Head injury decision rules in pediatric patients

Abstract

Head injuries in pediatric patients are a common presentation in an acute care setting, and clinicians must decide whether the pediatric patient should undergo cranial computed tomography (CT). There are many CT scanners available in Japan, rendering immediate CT examinations possible in the emergency departments. However, the risk of radiation-induced cancer has been reported to be higher in Japan compared with that in Western countries. To date, three clinical decisions rules (PECARN, CATCH, and CHALICE) have been reported to determine the need for CT in children with head injuries. These clinical decision rules have been developed to identify children at a high risk of intracranial injuries, aiming to assist clinicians in minimizing the number of CT scans. If however, when the family of a pediatric patient expects a head CT examination to determine the extent of the injury, the clinicians should recommend CT. Furthermore, it is important to assess the suitability of the head CT scanner used on the basis of the clinical decisions rules and to explain care post head injuries.