• Isaac O Kobe, Mahmoud M Qureshi, Saidi Hassan, and David L Oluoch-Olunya.
• Department of Surgery, The Aga Khan University Hospital, P.O BOX 30270-00100, Nairobi, Kenya. kobeisaac@yahoo.com.
• Childs Nerv Syst. 2017 Dec 1; 33 (12): 2147-2152.

BackgroundThe decision to order head CT scans to rule out clinically significant traumatic brain injury in mild head injury in children is made on the basis of clinical decision rules of which the Paediatric Emergency Care Applied Research Network (PECARN) CT head rules have been found to be most sensitive.PurposesThe purpose of this study is to determine the proportion of head CT scans done for children with mild head injury and to determine disposition of patients from casualty after the introduction of PECARN head CT rules compared to the period before. The research question is "will introduction of the PECARN CT head rules reduce the proportion of head CT scans requested for children under 18 years with mild head injury at the AKUHN?"MethodsA before and after quasi experimental study with a study population including all children under 18 years presenting to the AKUHN with mild head injury and a Glasgow coma scale of 14 and above on presentation. Sample size was 85.ResultsA total of 42 patients files were analysed in the before study while 43 patients were selected for the after study. The median age was 5 years. The proportion of head CT scans reduced from 56% in the before group to 33% in the after group with no missed clinically significant traumatic brain injury. More patients were discharged home after evaluation in the after group (81%) than in the before group (58%).ConclusionsThe number of head CT scans ordered reduced without missing any clinically significant traumatic brain injury.

29 keywords...

hide…