Relative has been brain injured - is it normal to go onto a ward, rather than HDU or ICU?

[Braininjuryquestion]

My relative has fractured his skull, is now unable to speak, is paralysed on one side and hospital are not going to operate. He has bled quite a lot, but is conscious. He was ambulanced into resus unit for several hours, was then moved to majors and will be going onto a ward. He will need very close monitoring and I don’t know what his new normal will look like. Is it normal to be moved onto a standard ward? I have no idea.

Admission to ICU/HDU will be determined by the consultant on call for referrals.
Ultimately they will be asking what as a department can we offer?
What is the patient age?
What are their chances of recovery?
What are they like in their normal activities of daily living?

Nobody can tell you what the new normal will be, its probably too early.
Depends what caused the original bleed.
Are they going to a stroke ward?

Normal ICU/HDU is for people who are medicaly unstable or need help with breathing or a trache. So it's good news if they are stable enough to be on ward. I imagine it will be a case of watching and waiting know to see how they respond to rehab or getting them well enough to start very gentle rehab.
I am very sorry for you and your relative, such a horrible situation
I have seen people make amazing recoveries in a month and people make very little recovery in w years. Its sometimes very hard to tell.

So sorry OP, for both you and your poor relative.

Huge sympathy with regards to the head injury, I've had three concussions, so nothing as serious as your relative but I understand how debilitating it is. Recovery is definitely possible and neuroplasticity too can certainly aid the brain with making new connections and healing.

How old is your relative?

if he is breathing on his own and doesn't need such large amounts of medications or any other support which wards can't offer then he will be on a ward. Is it at least a neuro ward?

When my son was in intensive care, 99% of patients were sedated and on life support.

It’s good news that he doesn’t need to go to ITU he must be medically stable enough to go onto a ward. It’s too early to say how he will do as he will need to
be assessed by various therapists first.

Sounds like they have had a traumatic brain injury rather than a stroke

Stroke ward would be kitted out with all the relevant services that the relatve would need though eg neurological observations, specialist OT/ PT/ Salt etc

A patient with a traumatic brain injury wouldn’t get a bed on a stroke ward. Those are dedicated to people who have had a stroke and are ring fenced. A patient with a traumatic Brian injury would go onto a neuro ward, if there is one in that particular hospital or onto a general medical ward.

I’m so sorry this has happened to you and your relative. It’s such a worrying time.

Your relative will likely be transferred to a Neuro ward. The nurses will be trained and skilled to spot subtle changes in your relative’s neurological condition. They will escalate to critical care quickly if this happens. They will be reviewed by a critical care doctor and a decision will be made to admit if necessary. They can be reviewed multiple times if things change.

If they are not requiring blood pressure support, airway management etc then a critical care bed is not needed at the moment.

Frustratingly, its very difficult to predict the trajectory your relative will take. Neuro patients are like a puzzle, you have to look at the scans, the patient and the progress as a whole. Scans are just a clue, not an answer. Time is often one of the main healers we have.

I hope your relative makes a swift recovery.

He’s about 80, was fully mobile, all his faculties, healthy etc. I know it’s just a waiting game at the moment as to what his new normal will be. It’s not a stroke, it’s a brain injury from cracking his head. He is breathing on his own, which is good. I just didn’t know if it was standard to go onto a normal ward.

sorry, it’s not a neuro ward.

A neuro ward would be more ideal but assuming the hospital doesn't have one then a general ward it will be. It's standard if he is stable and doesn't need support with breathing, blood pressure, a high amount of medication which can only be managed on intensive care etc.

I hope he's feeling better soon xx

Thank you for the responses. They said he might decline before he improves.

The ward will (ideally) have been chosen based on the assessment of his needs.

Non-specialist wards might seem to be all the same even when they're not.

Unfortunately many acute hospital trusts do not provide specialist Neuro wards and patients with complex needs can be placed on general medical wards. I would ask the team on the ward if he will be reviewed by neurology specialists doctors and therapists. Don’t just assume that he will be.

Yes when I read it, half asleep. I misunderstood

Neuro wards tend to have much younger patients with conditions like guillan barre etc, not older people with brain injuries.
It's normal to go to a general ward if he doesn't need breathing support.
They will likely make a decision over whether he needs a more specialist service over the coming days.
So sorry OP.

@Braininjuryquestion any update?

patients like this do v often go to stroke rehab wards

Unless he needs support breathing g etc then a normal ward would be usual

I'm so sorry OP how frightening for you all

Must depend on the hospital. I’ve had two friends who had brain injuries and both went to the stroke ward. One following an accident and the other was a hypoxic brain injury. Don’t think the hospital has a neuro ward so maybe that’s why.

when my dad was poorly an outreach person from icu came to see him on the ward and said admission criteria was basically did he need major organ support…breathing, kidneys I think he said….not sure about heart. So he wasn’t admitted even though very sick.