Presenting to hospital emergency: Analysis of clinical notes for Indigenous and non-Indigenous patients with traumatic brain injury in North Queensland

This study, led by two Aboriginal disability researchers using Indigenous standpoint theory, sought to identify, analyse and compare themes that emerged in the clinical notes of patients who presented with a Traumatic Brain Injury (TBI) to North Queensland hospital emergency departments. We analysed the clinical notes and identified six key themes that are relevant to understanding the differences in hospital emergency department characteristics of Indigenous and non-Indigenous people presenting with TBI in North Queensland. The themes are alcohol and assault; accidents and mishaps; traffic incidents; police involvement, non-compliance and/or aggression; sports; and seizures. Alcohol and assaults are a serious problem leading up to hospital presentations for Indigenous people. The themes together depict the chains of circumstances leading up to presentations along three dimensions: misadventure linked with mishaps in life; alcohol and violence; and individual health status. The study findings have implications for preventative health care policy and practice to reduce the main characteristics - alcohol and violence - contributing to Indigenous people presenting with TBI. The findings of this study provide evidence to inform the substance abuse policies and programs funded under the Closing the Gap strategy, the National Disability Insurance Scheme and the National Drug Strategy 2017-2026.