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A Specialized Pediatric Emergency Medicine Track Decreases Computed Tomography in Head Injured Patients

Heather B Conrad, Kathryn A Hollenbach, Kristin Ratnayake

  • 1San Diego State University, San Diego, CA.

Pediatric Emergency Care
|June 18, 2019
PubMed

Insights

Implementing a pediatric emergency track significantly reduced head computed tomography (CT) use in children with head injuries. This specialized care model in community emergency departments lowers radiation exposure for pediatric patients.

Area of Science:

  • Pediatric Emergency Medicine
  • Radiology and Imaging
  • Public Health

Background:

  • Growing concern over ionizing radiation exposure in pediatric patients.
  • Pediatric Emergency Care Applied Research Network guidelines aid in identifying low-risk head injury cases.
  • Need for strategies to optimize imaging in pediatric head trauma.

Purpose of the Study:

  • To evaluate the impact of a dedicated pediatric emergency track on head CT utilization in children under 15 with head injuries.
  • To assess if specialized pediatric emergency physicians reduce unnecessary CT scans.
  • To analyze changes in CT rates before and after the pediatric track's implementation.

Main Methods:

  • Retrospective cohort analysis of pediatric head injury patients (under 15 years).
  • Comparison of CT utilization in the year before and the year of pediatric track establishment.
  • Use of relative risk estimates to assess provider influence on CT decisions.

Main Results:

  • Head CT utilization decreased from 47.09% to 17.17% after implementing the pediatric track.
  • Pediatric patients were 2.2 times more likely to receive a head CT before the track's inception.
  • The study analyzed data from 11,094 and 14,639 pediatric patients over two fiscal years.

Conclusions:

  • The establishment of a pediatric emergency track led to a significant reduction in head CT scans for pediatric head injuries.
  • Developing specialized pediatric tracks in community emergency departments is effective in decreasing CT utilization.
  • This approach contributes to minimizing radiation exposure in children.
Abstract

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