Use of sedation in children receiving computed tomography after head injuries

Goldwasser, Tammy; Bressan, Silvia; Oakley, Ed; Arpone, Marta; Babl, Franz E

doi:10.1097/mej.0000000000000201

Cited by 20 publications

(20 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…2 -4 Moreover, CT use is resourceintensive and carries additional risks for children who require sedation for imaging. 5,6 In the United States, CT neuroimaging for pediatric head trauma nearly doubled from 1995 to 2003, 7 and there exists significant ongoing practice variation. 8 -10 Identifying children who are at low risk of clinically important TBI for whom CT can be safely avoided has become an international priority and has been the objective of several of the largest multicenter studies ever conducted in pediatric medicine.…”

Section: What's Known On This Subjectmentioning

confidence: 99%

Use of CT for Head Trauma: 2007–2015

et al. 2018

View full text Add to dashboard Cite

show abstract

Section: What's Known On This Subjectmentioning

confidence: 99%

Use of CT for Head Trauma: 2007–2015

et al. 2018

View full text Add to dashboard Cite

show abstract

“…In addition to the cost of the procedure, radiographic studies to investigate possible CSI expose the child to radiation that increases long‐term cancer risks . Younger children may also need sedation or a general anaesthesia to facilitate trauma‐related radiological tests …”

Section: Introductionmentioning

confidence: 99%

Clinical clearance and imaging for possible cervical spine injury in children in the emergency department: A retrospective cohort study

Hopper

McKenna

Williams

et al. 2019

Emerg Medicine Australasia

View full text Add to dashboard Cite

Objectives While cervical spine injuries (CSIs) are rare in the paediatric population, presentations to EDs with possible neck injuries are common. Based on a lack of Australian data we set out to determine how many possible injuries are clinically cleared, what imaging is used on the remainder and the incidence and characteristics of confirmed paediatric CSIs. Methods We undertook a retrospective electronic medical record review of children <18 years with potential CSIs at a large tertiary paediatric trauma centre in Victoria, Australia over a 12 month period (annual census 87 000). For possible injuries we extracted key epidemiologic, imaging and short‐term outcome data. Results During the study period, a total of 617 patients with potential neck injuries were seen in the ED (617/87 000, 0.7%). The median age was 11 years. The most common mechanisms of injury were falls (41%), motor vehicle injuries (28%) and sports‐related injuries (24%). Four hundred and fourteen of 617 (67%) underwent neck imaging (345/414, 83% plain radiograph; 100/414, 24% computed tomography; 7/414, 1.6% magnetic resonance imaging). Twenty‐three of 617 (4.1%) had radiologically documented CSIs. Two required operative interventions for their neck injuries. Conclusion While two‐thirds of children with potential CSIs undergo radiological evaluation, actual injuries are rare (<4%). These data suggest that there is a potential for improved targeting of cervical spine imaging for trauma. The development of a clinical decision tool may help reduce neck radiography.

show abstract

“…They are generally designed to determine which patients should or should not undergo CT of the head by stratifying patients into those at increased or decreased risk of intracranial injury (ICI). In children with head injuries, concerns about diagnostic speed, accuracy, resource use and variation in practice are amplified by concerns about radiation exposure and subsequent iatrogenic cancer risk1 2 and the need for sedation in young and uncooperative patients 3…”

Section: Introductionmentioning

confidence: 99%