• American College of Emergency Physicians Clinical Policies Subcommittee (Writing Committee) on Mild Traumatic Brain Injury, Jonathan H Valente, John D Anderson, William F Paolo, Kelly Sarmiento, Christian A Tomaszewski, Jason S Haukoos, Deborah B Diercks, Members of the American College of Emergency Physicians Clinical Policies Committee (Oversight Committee), Richard Byyny, Christopher R Carpenter, Benjamin Friedman, Seth R Gemme, Charles J Gerardo, Steven A Godwin, Sigrid A Hahn, Benjamin W Hatten, Amy Kaji, Heemun Kwok, Bruce M Lo, Sharon E Mace, Maggie Moran, Susan B Promes, Kaushal H Shah, Richard D Shih, Scott M Silvers, Andrea Slivinski, Michael D Smith, ThiessenMolly E WMEW, Stacy Trent, Stephen P Wall, Lauren M Westafer, Yanling Yu, Stephen V Cantrill, John T Finnell, Travis Schulz, and Kaeli Vandertulip.
• Ann Emerg Med. 2023 May 1; 81 (5): e63e105e63-e105.

AbstractThis 2023 Clinical Policy from the American College of Emergency Physicians is an update of the 2008 “Clinical Policy: Neuroimaging and Decisionmaking in Adult Mild Traumatic Brain Injury in the Acute Setting.” A writing subcommittee conducted a systematic review of the literature to derive evidence-based recommendations to answer the following questions: 1) In the adult emergency department patient presenting with minor head injury, are there clinical decision tools to identify patients who do not require a head computed tomography? 2) In the adult emergency department patient presenting with minor head injury, a normal baseline neurologic examination, and taking an anticoagulant or antiplatelet medication, is discharge safe after a single head computed tomography? and 3) In the adult emergency department patient diagnosed with mild traumatic brain injury or concussion, are there clinical decision tools or factors to identify patients requiring follow-up care for postconcussive syndrome or to identify patients with delayed sequelae after emergency department discharge? Evidence was graded and recommendations were made based on the strength of the available data. Widespread and consistent implementation of evidence-based clinical recommendations is warranted to improve patient care.

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