Skip to content

Children's Health

Observation After Head Injury Cuts Kids’ CT Scans

Study Shows Advantages of Postponing CT Scans in Emergency Rooms
Font Size
A
A
A
By
WebMD Health News
Reviewed by Laura J. Martin, MD

May 9, 2011 -- A period of observation in the emergency department after a minor childhood head injury can reduce the use of a CT scan by as much as half without affecting good care, according to a new study.

As a result, the child may be exposed to less radiation. That reduces the long-term risks, such as the link with accumulated radiation exposure and cancers.

"We document that observation after minor blunt head trauma reduces CT scan use without missing important injuries," says researcher Lise Nigrovic, MD, MPH, attending physician in emergency medicine at Children's Hospital Boston and assistant professor of pediatrics at Harvard Medical School.

With other researchers from the federally funded Pediatric Emergency Care Applied Research Network, Nigrovic evaluated more than 40,000 children. All were under age 18 and had minor blunt head trauma. They had been brought to one of 25 emergency departments between June 2004 and September 2006.

The study is published in Pediatrics.

Observation vs. CT Scan

Of the 42,412 children enrolled in the study, the researchers analyzed 40,113.

The minor head trauma occurred in a variety of ways, Nigrovic tells WebMD. "In the youngest, the most common is a fall, such as rolling off the bed, or running at high speed into another object."

For older children, the head injuries were often the result of sports activity or car accidents.

Of the 40,113 children, 5433 (14%) of the children were observed before making a decision on CT.

The CT use was lower in those who were observed than in those not -- 31.1% compared to 35%.

However, the rate of clinically important traumatic brain injury found in both groups was similar.

The researchers did not determine the actual observation time. However, guidelines from the American Academy of Pediatrics recommend a child be observed carefully for four to six hours after such injuries.

During the observation period, doctors check for changes in mental status, changes in vital signs (blood pressure, etc.) and any increase in nausea or pain.

The researchers matched the observed and non-observed for severity of injury and the practice patterns of various hospitals. They found the likelihood of a CT scan in the observed group was about half that of the similar non-observed patients.

1 | 2 | 3

Today on WebMD

child with red rash on cheeks
What’s that rash?
plate of fruit and veggies
How healthy is your child’s diet?
 
smiling baby
Treating diarrhea, fever and more.
Middle school band practice
Understanding your child’s changing body.
 

worried kid
fitArticle
boy on father's shoulder
Article
 
Child with red rash on cheeks
Slideshow
girl thinking
Article
 

Loaded with tips to help you avoid food allergy triggers.

Loading ...

Sending your email...

This feature is temporarily unavailable. Please try again later.

Thanks!

Now check your email account on your mobile phone to download your new app.

babyapp
New
Child with adhd
Slideshow
 
rl with friends
fitSlideshow
Syringes and graph illustration
Tool