Paediatric minor head injury applied to Paediatric Emergency Care Applied Research Network CT recommendations: An audit

BackgroundTraumatic brain injury (TBI) is a common cause of paediatric morbidity and mortality, with higher TBI rates in low- and middle-income countries. Non-contrast brain CT is the gold standard for diagnosing intracranial injuries; however, it exposes patients to ionising radiation. The Paediatr...

Full description

Saved in:
Bibliographic Details
Published in:SA journal of radiology Vol. 26; no. 1; pp. 2289 - 7
Main Authors: du Plessis, Jacques, Gounden, Sharadini K., Lewis, Carolyn
Format: Journal Article
Language:English
Published: South Africa AOSIS 2022
African Online Scientific Information Systems (Pty) Ltd t/a AOSIS
AOSIS (Pty) Ltd
Radiological Society of South Africa
Subjects:
Age
Archives & records
Brain
Brain research
Children
Computed tomography
computed tomography (CT)
CT imaging
Decision making
Diagnostic imaging
diagnostic reference levels
Emergency medical care
Head injuries
Health Care Sciences & Services
Injuries
ionising radiation
Low income groups
low- and middle-income countries
Medical imaging
Medical records
Medicine, General & Internal
minor head injuries
Morbidity
Mortality
Neuroimaging
Original Research
paediatric trauma
Patients
PECARN
Pediatric emergencies
Pediatrics
Radiation
Radiology, Nuclear Medicine & Medical Imaging
Risk groups
South Africa
Trauma
Traumatic brain injury
South Africa
United States > US
PECARN
diagnostic reference levels
ionising radiation
computed tomography (CT)
paediatric trauma
traumatic brain injury
minor head injuries
low- and middle-income countries
ISSN:1027-202X, 2078-6778, 2078-6778
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:BackgroundTraumatic brain injury (TBI) is a common cause of paediatric morbidity and mortality, with higher TBI rates in low- and middle-income countries. Non-contrast brain CT is the gold standard for diagnosing intracranial injuries; however, it exposes patients to ionising radiation. The Paediatric Emergency Care Applied Research Network (PECARN) clinical decision rule (CDR) aids clinicians in their decision-making processes whilst deciding whether a patient at very low risk of a clinically important TBI (ciTBI) requires a CT scan.ObjectivesTo establish whether the introduction of the PECARN CDR would affect CT utilisation rates for paediatric patients presenting with minor blunt head injuries to an academic hospital in Gauteng, South Africa.MethodThis was an audit of paediatric patients who presented with minor blunt head injuries and were referred for CT imaging at an academic hospital in Gauteng, compared with PECARN CDR recommendations, over a 1-year period.ResultsA total of 100 patients were referred for CT imaging. Twenty patients were classified as very low risk, none of whom had any CT findings of a TBI or ciTBI (p < 0.01). A total of 61 patients were classified as intermediate risk and 19 as high risk. In all, 23% of the intermediate and 47% of the high-risk patients had CT features of a TBI, whilst 8% and 37% had a ciTBI, respectively.ConclusionComputed tomography brain imaging may be omitted in patients classified as very low risk without missing a clinically important TBI. Implementing the PECARN CDR in appropriate patients would reduce CT utilisation rates.
Bibliography:ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
content type line 14
content type line 23
ISSN:1027-202X
2078-6778
2078-6778
DOI:10.4102/sajr.v26i1.2289