724 Head Injuries in Children: Is it Nice to Ct Scan?

Abstract

Introduction: Trauma is commonest cause of hospital admission in children and head injuries account for 75% of children admitted. Head injury is one of common causes of acquired neurological and cognitive disability in childhood. Indications for CT scan in evaluation of children with head injury are well documented in NICE Guidelines. Aim: To evaluate our practice for children attending A&E department with head injury at district general hospital in comparison with NICE guidelines Method: This was a retrospective audit of case notes of all children below 16 years age, attending the hospital's emergency department with head injury. Information was collected over two month period. Case notes were analysed to record Glasgow coma scale, children admitted for neurology observation and whether the NICE guidelines for computed tomography scan was followed. Results: Of 120 children with head injury who attended A&E, 107 full case notes were available. In total 13/107 children (12%) met the criteria for CT scan. However 6/13 children (46%) were sent home after clinical assessment at the discretion of attending physician. 7/13 (54%) were admitted for 24 hours neurology observation of which 3/13 underwent CT scan. Head injury leaflet was given to all children. Conclusions: This study reiterates continual awareness of NICE guidelines amongst physicians for highest quality care.However as evident in this study, it may require a four fold increase in the number ofCTscans being otherwise done. Thismay not be possible at a district general hospital due to local constraints of radiology and can be circumvented by proper clinical assessment and follow up with a head injury advice booklet as shown in our study.