Emergency room upgrade: helping kids avoid unneeded CT scans, radiation

New medical guidelines may reduce unnecessary CT scans, and the associated radiation, for children with head injuries.

That’s according to Professor Stuart Dalziel, who’s the Cure Kids Chair of Child Health Research at the University of Auckland, and a paediatric emergency physician at Starship Children’s Hospital in Auckland.

New Zealand and Australia have come up with their first joint guidelines for emergency doctors diagnosing and treating mild to moderate head injuries in children.

Professor Dalziel was one of the specialists who contributed to the guidelines, developed by the Paediatric Research in Emergency Departments International Collaborative (PREDICT) and the Murdoch Children’s Research Institute (MCRI) in Australia.

The new approach may help to ensure more consistent treatment, he said.

Head injury is one of the most common reasons for children to present to emergency departments.
In Australia and New Zealand about 10 per cent of children who present with head injuries of all severities have CT scans. Despite traumatic brain injuries being uncommon, persistent post-concussive symptoms affect more than a third.

Professor Franz Babl, MCRI Group Leader of Emergency Research, said Australia and New Zealand have not had a specific set of guidelines to help clinicians decide how best to treat individual children under 18 years who come to the emergency department with mild to moderate head injury.

“While we need to rule out any bleeding in the brain, we don’t want to order CT scans unnecessarily, because it increases children’s lifetime radiation exposure,” he said. “The lack of standardised guidelines meant children were receiving different care depending on where they were seen. Widespread uptake of these guidelines will change that.”

The guidelines will be published in Emergency Medicine Australasia and available at www.predict.org.au

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