Annals of Emergency Medicine
Volume 49, Issue 3 , Pages 320-324 , March 2007

Pediatric Head Trauma: Changes in Use of Computed Tomography in Emergency Departments in the United States Over Time

Presented at the Society for Pediatric Research, May 2004, San Francisco, CA.

  • Charles D. Blackwell, MD

      Affiliations

    • Department of Emergency Medicine, Children's Hospitals and Clinics of Minnesota, Minneapolis, MN (Blackwell)
    • Corresponding Author InformationAddress for correspondence: Charles D. Blackwell, MD, Children's Hospitals and Clinics of Minnesota, 2525 Chicago Avenue South, Minneapolis, MN 55404; 612-813-6843, fax 612-813-7362;
    • ,
  • Marc Gorelick, MD, MSCE

      Affiliations

    • the Department of Pediatrics, Medical College of Wisconsin, Children's Research Institute, Children's Hospital of Wisconsin, Milwaukee, WI (Gorelick)
    • ,
  • James F. Holmes, MD, MPH

      Affiliations

    • the Departments of Emergency Medicine (Holmes, Kuppermann)
    • ,
  • Subhankar Bandyopadhyay, MD

      Affiliations

    • University of California, Davis School of Medicine, Davis, CA; and the Department of Pediatrics, Emergency Medicine Division, Emory University School of Medicine and Children's Healthcare of Atlanta at Egleston, Atlanta, GA (Bandyopadhyay)
    • ,
  • Nathan Kuppermann, MD, MPH

      Affiliations

    • the Departments of Emergency Medicine (Holmes, Kuppermann)
    • and Pediatrics (Kuppermann)

Received 16 June 2006 ,Revised 13 September 2006 ,Accepted 29 September 2006.

References 

  1. Klassen TP, Reed MH, Stiell IG, et al. Variation in utilization of computed tomography scanning for the investigation of minor head trauma in children: a Canadian experience. Acad Emerg Med. 2000;7:739–744
  2. Stiell IG, Wells GA, Vandemheen K, et al. Variation in ED use of computed tomography for patients with minor head injury. Ann Emerg Med. 1997;30:14–22
  3. Oman JA, Cooper RJ, Holmes JF the NEXUS II investigators. The performance of a decision rule to predict need for computed tomography among children with blunt head trauma. Pediatrics. 2006;117:e238–e246
  4. Simon B, Letourneau P, Vitorino E, et al. Pediatric minor head trauma: indications for computed tomographic scanning revisited. J Trauma. 2001;51:231–238
  5. Palchak MJ, Holmes JF, Vance CW, et al. A decision rule for identifying children at low risk for brain injuries after blunt head trauma. Ann Emerg Med. 2003;42:492–506
  6. Commission on Clinical Policies and Research, American Academy of Pediatrics. Committee on Quality Improvement. American Academy of Pediatrics. The management of minor closed head injury in children. Pediatrics. 1999;104:1407–1415
  7. Homer CJ, Kleinman L. Technical report: minor head injury in children. Pediatrics. 1999;104:e78
  8. National Center for Health Statistics NHAMCS Description. http://www.cdc.gov/nchs/about/major/ahcd/nhamcsds.htm2006;
  9. Shunk JE, Rodgerson JD, Woodward GA. The utility of head computed tomographic scanning in pediatric patients with normal neurologic examination in the emergency department. Pediatr Emerg Care. 1996;12:160–165
  10. Brenner DJ. Estimating cancer risks from pediatric CT: going from the qualitative to the quantitative. Pediatr Radiol. 2002;32:228-223

 Supervising editor: Kathy N. Shaw, MD, MSCE

 Author contributions: CDB, MG, and NK conceived the study. CDB and MG performed data collection from the NHAMCS database. MG provided statistical advice on study design. CDB and MG performed the main data analysis. JFH, SB, and NK contributed to data analysis and interpretation. CDB drafted the article, and all authors contributed substantially to its revision. CDB takes responsibility for the paper as a whole.

 Funding and support: The authors report this study did not receive any outside funding or support.

 Reprints not available from the authors.

PII: S0196-0644(06)02342-0

doi: 10.1016/j.annemergmed.2006.09.025

Annals of Emergency Medicine
Volume 49, Issue 3 , Pages 320-324 , March 2007

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