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This a request for information to support the SNOMED Quality Improvement project.

There are a number classification concepts currently within the terminology which are of the form:

450569000 |Traumatic brain injury with loss of consciousness one hour or more (disorder)|

in addition there seems to be an overlap between the use of the terminology to describe coma v loss of consciousness.

A review of the current practice for management of brain injury (NICE and ACS) suggests that assessment should be based upon the application of the 3 separate elements of the Glasgow Coma Score. and it is these separate scores which should be used as the means of communicating the patients status between clinicians and within the patients notes.

If this is the approved international approach to recording the mental/coma status of head injury patients we would like to inactivate the complex individual statements relating to coma/concussion on the basis that all of the individual elements of the GCS are available within the terminology.

There are 173 concepts in the hierarchy of 127294003 |Traumatic AND/OR non-traumatic brain injury (disorder)| which include the word concussion and the list of these is attached to this discussion thread.

We would be grateful for you views.

Many thanks
Paul
Paul Amos


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