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A matched-cohort study of pediatric head injuries: collecting data to inform an evidence-based triage assessment

Elizabeth Stone Griffin1, Steven J Lippmann1, Debbie A Travers1

  • 1Raleigh and Chapel Hill, NC.

Journal of Emergency Nursing
|September 14, 2013
PubMed

Insights

Pediatric head injuries are challenging to assess, especially in young children. This study highlights the need for a nurse-driven tool to identify high-risk children with closed head injuries (CHI).

Area of Science:

  • Pediatric Emergency Medicine
  • Trauma Surgery
  • Nursing Assessment

Background:

  • Triage nurses are the initial point of contact for pediatric patients in emergency departments.
  • Assessing pediatric head injuries is complex, as symptoms often don't correlate with the risk of closed head injury (CHI).

Purpose of the Study:

  • To inform the development of a nurse-driven pediatric head injury assessment tool.
  • To identify key indicators for closed head injury (CHI) in pediatric patients.

Main Methods:

  • A retrospective matched cohort study compared CHI-positive and CHI-negative pediatric patients.
  • Data was collected via chart review from a pediatric emergency department.

Main Results:

  • Younger children with head injuries were more likely to be asymptomatic.
  • Scalp hematomas in infants under 3 months were linked to CHI, even without other symptoms.
  • Temporal-parietal injuries and minor falls were associated with CHI across all age groups.
  • Loss of consciousness (LOC) reporting was similar between CHI-positive and CHI-negative groups.

Conclusions:

  • Infants and children at highest risk for CHI are often the most challenging to assess.
  • An evidence-based, nurse-driven risk scoring system is needed for early identification of high-risk pediatric CHI cases.
Abstract

Keywords:
AssessmentHead injuryHead traumaPediatricTriage

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