Head injuries were a common reason for ICU admission and associated with the highest mortality rates in this audit. This is not surprising, considering that the study ICU is a general ICU and does not have specialised neurocritical care resources (e.g. facilities to measure intracranial pressure or arterial blood gases). This is despite the ICU being served by four neurosurgeons; therefore the limitations are related to infrastructure rather than skills or personnel. It was difficult to determine what proportion of deaths was preventable because reliable data for this was not available.