A study of children with minor head trauma at Boston Children’s Hospital suggests CT scans may not be necessary when diagnosing children who have suffered head trauma.
The study indicates that the use of a CT scan can be reduced by up to 50% without compromising care simply by observing children. This is a positive finding because reducing CT Scans reduces children’s exposure to unnecessary radiation.
The June issue of Pediatrics Journal contains the results of a study lead by Boston Children’s Hospital and the Department of Emergency Medicine at UC Davis. One of the co-authors of the study Lise Nigrovic stated:
“Only a small percentage of children with blunt head trauma really have something serious going on. If you can be watched in the ED for a few hours, you may not need a CT”.
The study reviewed the results of more than 40,000 children who had been admitted to emergency departments with blunt head trauma. Some of the children had CT scans ordered immediately. Others were observed before a decision was made about the use of a CT scan.
More Observation = Fewer CT Scans
The authors of the report found the children who were observed had a lower rate of CT Scans then those who were not observed.
The authors found the allowing for an observation period did not compromise the safety of the children. Significant brain injury or injuries requiring surgical intervention was almost equal in both the observed and non-observed groups.
The findings are significant because CT Scans present a risk to children. A child’s growing brain tissue is more sensitive to radiation then adults. Therefore, any exposure to radiation increases the risk of developing a radiation induced cancer later in life.
Guidelines for Parents
Nigrovic suggested the following guidelines for parents to be aware of if their children have suffered a head injury:
1. Check with your family doctor before taking your child to the emergency department;
2. If your child has a headache, vomiting and or confusion, take them to the emergency department immediately;
3. An emergency department physician may choose to observe your child before making a decision about whether to order a CT Scan;
4. Changing symptoms over time (either increasing severity or decreasing severity) is an important factor in deciding whether to order a head CT Scan.
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