Evaluation of Pediatric Patients Admitted to the Emergency Department with Head Trauma

Abstract

Aim: Head trauma is the most frequent reason for trauma related child deaths. Minor head traumas (MHT) form a considerable part of pediatric head traumas. Computed Brain Tomography (CBT) is the gold standard for demonstrating intracranial pathologies in patients with head trauma. It is necessary to avoid having unnecessary CT scans in order to reduce the cost and the harms of radiation. We aim to assess the pediatric patients that applied to the emergency service with complaints of head trauma in the light of Prediction of Important Clinical Events (CHALICE) clinical decision-making rules. Materials and Methods: 200 patients under 18 years old who applied to the emergency service with complaints of head trauma between 2016 and 2019 are included in this retrospective study. Results: 200 patients in total were included in the study; of them, 128 are males and 72 are females. Of the patients, 3 have a Glaskow Coma Score (GCS) of 3-8, 2 have a GCS of 9-13, and the remaining 195 patients have a GCS of 14-15. Considering the symptoms, 35 patients had a headache, 28 patients had subcutaneous hematoma, and 26 patients had nausea-vomiting. The reason for trauma is motor vehicle accident for 99 patients and falling down from height for 95 patients. Four patients died. CHALICE (+) rate was found 67.82% in the patients having a CBT scan. 41.95% of asymptomatic patients had a CBT scan. Conclusion: The results of our study showed that despite all academic efforts, unnecessary CT rates in pediatric head injuries could not be reduced.

Keywords

• pediatric head trauma
• chalice
• computed brain tomography
• defensive medicine
• traumatic brain damage
• minor head trauma
• çocuk kafa travması
• chalice
• bilgisayarlı beyin tomografisi
• defansif tıp
• travmatik beyin hasarı
• minor kafa travması