Clinical judgment versus PECARN in detecting the need for computed tomography scan in minor pediatric head trauma

Alkafafy, Asmaa M.; Gaber, Eman M.; Fouad, Wael; Metwaly, Tamer

doi:10.4103/ejs.ejs_265_21

Clinical judgment versus PECARN in detecting the need for computed tomography scan in minor pediatric head trauma

Authors

Abstract

Background and objective
Head trauma occurs commonly in childhood. Most head trauma in children is minor and not associated with brain injury or long-term sequelae. However, a small number of children who appear to be at low risk may have a clinically important traumatic brain injury. The objective of this study was to detect the overuse of computed tomography (CT) scan, based on comparing personal clinical judgment of emergency physician to PECARN tool after minor blunt head injury among pediatric patients in the Emergency Department.
Patients and methods
In this prospective observational study, 50 pediatric patients aged from 2 to 18 years old with minor blunt head trauma at the Emergency Department were enrolled. All patients were investigated using CT.
Results
Clinical judgment alone was associated with an increase in using CT scan in all enrolled patients compared with using a clinical decision tool like ‘PECARN.’
Conclusion
CT scan for evaluation of minor blunt head trauma in children is currently overused, thus exposing children to unnecessary radiations.