Towards evidence-based emergency medicine: best BETs from the Manchester Royal Infirmary. BET 3: Management of paediatric minor head injuries: safe discharge?
A short-cut review was carried out to establish whether the finding of a normal cranial CT scan, in a child with a history of minor head injury, a Glasgow coma scale (GCS) score of 15 and normal neurological examination could facilitate safe discharge from hospital. Ninety-eight articles were found using the reported search and a further two papers were found from the references of selected papers. A total of 11 trials were included with one prospective cohort study including 13,543 patients. The authors, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these papers are tabulated (table 3). It is concluded that in the absence of any coagulation problems, a child who presents following a minor head injury with a GCS of 15, normal neurological examination and a normal CT scan can be safely discharged to the care of a capable parent.
Yorkhill Hospital, Glasgow, UK.
Fiona
F
Hunter
Vincent
V
Choudhery
D002648:Child; D006259:Craniocerebral Trauma / Q000000981:diagnostic imaging*; D055416:Evidence-Based Emergency Medicine; D015600:Glasgow Coma Scale; D006801:Humans; D010351:Patient Discharge; D061214:Patient Safety; D014057:Tomography, X-Ray Computed