Which Management Strategy Do Parents Prefer for Their Head-Injured Child

Karpas, Anna; Finkelstein, Marsha; Reid, Samuel

doi:10.1097/pec.0b013e31827b5090

Cited by 18 publications

(17 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…20 The clinician shows the parents a visual depiction of a CT scanner to give them a better idea what undergoing a CT would be like for their child and describe the specific symptoms they would need to watch for should they opt to further observe their child at home after ED discharge rather than undergo head CT. Finally, the clinician highlights the key benefits and trade-offs 27 associated with head CT versus home observation: speed of diagnosis, radiation exposure, 28 possible need for sedation, cost, potential to identify incidental or irrelevant abnormalities on the CT scan, and the anticipated wait in the ED.…”

Section: Case 1: a 7-year-old Male With Minor Head Traumamentioning

confidence: 99%

Shared Decision-making in the Emergency Department: Respecting Patient Autonomy When Seconds Count

Hess

Grudzen²,

Thomson

et al. 2015

Acad Emerg Med

View full text Add to dashboard Cite

Shared decision-making (SDM), a collaborative process in which patients and providers make health care decisions together, taking into account the best scientific evidence available, as well as the patient's values and preferences, is being increasingly advocated as the optimal approach to decision-making for many health care decisions. The rapidly paced and often chaotic environment of the emergency department (ED), however, is a unique clinical setting that offers many practical and contextual challenges. Despite these challenges, in a recent survey emergency physicians reported there to be more than one reasonable management option for over 50% of their patients and that they take an SDM approach in 58% of such patients. SDM has also been selected as the topic on which to develop a future research agenda at the 2016 Academic Emergency Medicine consensus conference, "Shared Decisionmaking in the Emergency Department: Development of a Policy-relevant Patient-centered Research Agenda" (http://www.saem.org/annual-meeting/education/2016-aem-consensus-conference). In this paper the authors describe the conceptual model of SDM as originally conceived by Charles and Gafni and highlight aspects of the model relevant to the practice of emergency medicine. In addition, through the use of vignettes from the authors' clinical practices, the applicability of SDM to contemporary EM practice is illustrated and the ethical and pragmatic implications of taking an SDM approach are explored. It is hoped that this document will be read in advance of the 2016 Academic Emergency Medicine consensus conference, to facilitate group discussions at the conference.ACADEMIC EMERGENCY MEDICINE 2015;22:856-864

show abstract

Section: Case 1: a 7-year-old Male With Minor Head Traumamentioning

confidence: 99%

Shared Decision-making in the Emergency Department: Respecting Patient Autonomy When Seconds Count

Hess

Grudzen²,

Thomson

et al. 2015

Acad Emerg Med

View full text Add to dashboard Cite

show abstract

“…Recent studies suggest that parents prefer observation instead of immediate neuroimaging, after the risks and benefits of both options have been presented. 21 One of the leading reasons against neuroimaging was concern about radiation risks. Observing patients after minor head trauma with an intermediate risk of TBI can significantly reduce the rate of cerebral CT scans.…”

Section: Discussionmentioning

confidence: 99%

Can a CT be Omitted in Pediatric Minor Head Trauma?

et al. 2017

View full text Add to dashboard Cite

This study aimed to evaluate the need for radiation exposure in pediatric minor head trauma. Symptomatic patients after minor head trauma were observed for at least 24 hours in a 13-month period. A computed tomography (CT) scan was performed on children with a depressed neurological status. Two hundred fourteen patients with a mean age of 9.3 years were included. An intracranial hemorrhage (ICH) was diagnosed in three (1.4%) patients. The overall CT rate was 10.7%. The study concluded that neuro-observation without initial CT scans is safe in infants and children following minor head trauma. Special pediatric CT protocol can limit radiation exposure.

show abstract

“…In a recent survey of parents of children with head trauma, the majority preferred observation to immediate CT after a standardised education about the risks of ionizing radiation 20. In a second survey of parents of ED patients, approximately half were aware of the risks of ionizing radiation from diagnostic CT scans 21.…”

Section: Discussionmentioning

confidence: 99%

Republished: Pediatric Emergency Care Applied Research Network head injury clinical prediction rules are reliable in practice

Schonfeld

Bressan

Dalt

et al. 2015

Postgraduate Medical Journal

View full text Add to dashboard Cite

show abstract

Which Management Strategy Do Parents Prefer for Their Head-Injured Child

Abstract: When given the opportunity to make an informed decision regarding the evaluation of their head-injured child, parents were divided as to their preference. A small majority preferred observation.

Cited by 18 publications

References 22 publications

Shared Decision-making in the Emergency Department: Respecting Patient Autonomy When Seconds Count

Shared Decision-making in the Emergency Department: Respecting Patient Autonomy When Seconds Count

Can a CT be Omitted in Pediatric Minor Head Trauma?

Republished: Pediatric Emergency Care Applied Research Network head injury clinical prediction rules are reliable in practice

Contact Info

Product

Resources

About