Children with minor head trauma are frequent presentations to emergency departments (EDs). Identifying those with traumatic brain injuries (TBIs) can be difficult. ED clinicians must decide who requires computed tomography (CT) scanning to evaluate for traumatic brain injury (TBI). The use of CThead in children has doubled over the last two decades, from 10.6 CTs per 1000 children in 1996 to 21.5 CTs per 1000 children in 2010. Ionizing radiation is particularly worrisome in children; it is estimated that 1 in 1000 to 1 in 5000 cranial CT scans result in a later lethal cancer. The Pediatric Emergency Care Applied Research Network (PECARN) derived and validated two age-based prediction rules to identify children at very low risk of clinically-important traumatic brain injuries (ciTBIs) who do not typically require CT scans. It is estimated that pediatric CT use for minor head trauma would decrease by 20%–25% while rarely missing a child with ciTBI.
Objective Is to analyze whether CT head is being appropriately utilized by health care professionals while identifying traumatic brain injury in pediatric patients presenting with trauma
Study Design is Retrospective Cross-sectional file review of patients coming to AgaKhan Hospital Emergency Department and sample size of 197; at confidence level of 95% and confidence interval of 5% including pediatric head trauma cases on whom CT scan was done
The anticipated result is that we burdened one out of four pediatric patients with extra radiation. PECARN rule will guide us to limit ordering unnecessary CT scans without missing traumatic brain injury.
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