eMedicineLive

It is a common practice for children taken to emergency department of any hospital following a head injury to receive a head CT scan. More often than not, the procedure is carried out just to allay the parents’ anxiety regarding the nature of the injury. But now, a study conducted by Children's Hospital Boston and UC Davis states that these unnecessary CT scans should be avoided.

According to Lise Nigrovic, MD, MPH, of Children's Hospital Boston, who co-led the study with Nathan Kuppermann, MD, MPH, chair of the Department of Emergency Medicine at UC Davis, traumatic brain injury is uncommon in children. By making a child undergo a CT scan, we are exposing him to unnecessary radiation. This can be avoided by simply observing the child in the ED for a few hours.

The researchers conducted a multicenter study involving more than 40,000 children who visited 25 different EDs of various hospitals with a minor blunt head trauma. This study was an initiative of the Pediatric Emergency Care Applied Research Network (PECARN).The results that will appear in the June 2011 issue of “Pediatrics” show that observing these children in the ED for some time reduced the number of head CT scans by half. Not only is observation more cost effective but is also better for the children in the long run.

In the study, about 14% of the children spent time under observation in the ED before a final call regarding CT scan was taken. The chances of children in the observed group being subjected to a CT scan were about half of the non observed group when different parameters like the severity of the head injury and the practices style of different hospitals were matched. An important observation of the study was that observation in the ED did not compromise the safety of the child. The likelihood of a clinically important traumatic injury of the brain was similar in both the observed and the non-observed group.

The growing brain tissue of a young child is more susceptible to ionizing radiation. The lifetime risk of developing a radiation induced malignancy is also greater in children. Therefore, observing a child, whose head injury isn’t obviously severe, for 4 to 6 hours in the ED, may spare him from unnecessary radiations without compromising on his safety.

References:

http://www.eurekalert.org/pub_releases/2011-05/chb-lsf050511.php