Reducing Computed Tomography Scan Utilization for Pediatric Minor Head Injury in the Emergency Department: A Quality Improvement Initiative

This study was conducted to evaluate the computed tomography findings in patient with acute head injury and to emphasize the importance of computed tomography scan in head injury. One hundred consecutive patients presenting to the emergency department with head injury were evaluated by computed tomography scan of the head. Seventy five patients (75%) were male and twenty five (25%) were females. The age of the patients ranged from three to seventy years and the most affected age group was between thirty and forty (40%). The common causes of head injury were motor vehicle accident (70%), fall injury (25% ) and physical assault (5%). The most common computed tomographic findings were: cerebral contusions (52%), skull fractures (41%), intracerebral hematomas (24%), diffuse cerebral edema (23%), midline shift (18%), subdural hematomas (15%), subarachnoid hemorrhage (13%), diffuse axonal injury (8%), intraventricular hemorrhage (6%), extradural hemotomas (4%), pnemocephalus (2%) and normal scans were found in (5%). In conclusion, computed tomography is the mainstay in the imaging of head injury and helps in the patient management. DOI: http://dx.doi.org/10.3126/jcmsn.v7i1.5971 JCMSN 2011; 7(1): 36-39

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Does Computed Tomography Scan of the Brain in Pediatric Non-head Injury Patients Influence their Management in the Acute Setting?

MGM Journal of Medical Sciences ◽

10.5005/jp-journals-10036-1208 ◽

2018 ◽

Vol 5 (4) ◽

pp. 150-153

Author(s):

Nikhil Bhuskute ◽

Nevine Anandan ◽

Alexander Johnson ◽

Soraya Hachemi ◽

Shalini Nandish

Keyword(s):

Computed Tomography ◽

Head Injury ◽

Computed Tomography Scan ◽

Acute Setting ◽

The Brain ◽

Tomography Scan

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Prediction Score for Cervical Spine Fracture in Patients with Traumatic Neck Injury

Neurology Research International ◽

10.1155/2021/6658679 ◽

2021 ◽

Vol 2021 ◽

pp. 1-6

Author(s):

Natsinee Athinartrattanapong ◽

Chaiyaporn Yuksen ◽

Sittichok Leela-amornsin ◽

Chetsadakon Jenpanitpong ◽

Sirote Wongwaisayawan ◽

...

Keyword(s):

Computed Tomography ◽

Emergency Department ◽

Cervical Spine ◽

Spine Fracture ◽

Prediction Score ◽

Spine Injury ◽

Cervical Spine Fracture ◽

Clinical Prediction ◽

Computed Tomography Scan ◽

Tomography Scan

Background. Cervical spine fracture is approximately 2%–5%. Diagnostic imaging in developing countries has several limitations. A computed tomography scan is not available 24 hours and not cost-effective. This study aims to develop a clinical tool to identify patients who must undergo a computed tomography scan to evaluate cervical spine fracture in a noncomputed tomography scan available hospital. Methods. The study was a diagnostic prediction rule. A retrospective cross-sectional study was conducted between August 1, 2016, and December 31, 2018, at the emergency department. This study included all patients aged over 16 years who had suspected cervical spine injury and underwent a computed tomography scan at the emergency department. The predictive model and prediction scores were developed via multivariable logistic regression analysis. Results. 375 patients met the criteria. 29 (7.73%) presented with cervical spine fracture on computed tomography scan and 346 did not. Five independent factors (i.e., high-risk mechanism of injury, paraparesis, paresthesia, limited range of motion of the neck, and associated chest or facial injury) were considered good predictors of C-spine fracture. The clinical prediction score for C-spine fracture was developed by dividing the patients into three probability groups (low, 0; moderate, 1–5; and high, 6–11), and the accuracy was 82.52%. In patients with a score of 1–5, the positive likelihood ratio for C-spine fracture was 1.46. Meanwhile, those with a score of 6–11 had an LR+ of 7.16. Conclusion. In a noncomputed tomography scan available hospital, traumatic spine injuries patients with a clinical prediction score ≥1 were associated with cervical spine fracture and should undergo computed tomography scan to evaluate C-spine fracture.

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