title: [New recommendations for the management of children after minor head trauma].
abstract: Minor head trauma is a common cause for pediatric emergency department visits. In 2009, the Pediatric Emergency Care Applied Research Network (PECARN) published a clinical prediction rule for identifying children at very low risk of clinically important traumatic brain injuries (ciTBI) and for reducing CT use because of malignancy induced by ionizing radiation. The prediction rule for ciTBI was derived and validated on 42,412 children in a prospective cohort study. The Société Française de Médecine d'Urgence (French Emergency Medicine Society) and the Groupe Francophone de Réanimation et Urgences Pédiatriques (French-Language Pediatric Emergency Care Group) recommend this algorithm for the management of children after minor head trauma. Based on clinical variables (history, symptoms, and physical examination findings), the algorithm assists in medical decision-making: CT scan, hospitalization for observation or discharge, according to three levels of ciTBI risk (high, intermediate, or low risk). The prediction rule sensitivity for children younger than 2 years is 100 % [86.3-100] and for those aged 2 years and older it is 96.8 % [89-99.6]. Our aim is to present these new recommendations for the management of children after minor head trauma.
authors.affiliation: Urgences pédiatriques, CHU de Nantes, 9, quai Moncousu, 44093 Nantes cedex 1, France. Electronic address: fleur.lorton@chu-nantes.fr.
authors.forename: F
authors.initials: F
authors.lastname: Lorton
authors.affiliation: Urgences pédiatriques, CHU de Nantes, 9, quai Moncousu, 44093 Nantes cedex 1, France.
authors.forename: K
authors.initials: K
authors.lastname: Levieux
authors.affiliation: Urgences pédiatriques, CHU de Nantes, 9, quai Moncousu, 44093 Nantes cedex 1, France.
authors.forename: B
authors.initials: B
authors.lastname: Vrignaud
authors.affiliation: Neurotraumatologie, CHU de Nantes, Hôtel-Dieu, 1, place Alexis-Ricordeau, 44093 Nantes cedex 1, France.
authors.forename: O
authors.initials: O
authors.lastname: Hamel
authors.affiliation: Urgences, hôpital Purpan, CHU de Toulouse, place du Docteur-Baylac, TSA 40031, 31059 Toulouse cedex 9, France.
authors.forename: E
authors.initials: E
authors.lastname: Jehlé
authors.affiliation: Chirurgie orthopédique pédiatrique, hôpital Femme-Enfant-Adolescent, CHU de Nantes, 38, boulevard Jean-Monnet, 44093 Nantes cedex 1, France.
authors.forename: A
authors.initials: A
authors.lastname: Hamel
authors.affiliation: Urgences pédiatriques, CHU de Nantes, 9, quai Moncousu, 44093 Nantes cedex 1, France.
authors.forename: C
authors.initials: C
authors.lastname: Gras-Leguen
mesh_terms: D001930:Brain Injuries / Q000097:blood / Q000175:diagnosis / Q000628:therapy; D002675:Child, Preschool; D003661:Decision Support Techniques; D003952:Diagnostic Imaging; D015600:Glasgow Coma Scale; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D010343:Patient Admission / Q000592:standards; D010351:Patient Discharge / Q000592:standards; D064568:S100 Calcium Binding Protein beta Subunit / Q000097:blood
chemical_list: D064568:S100 Calcium Binding Protein beta Subunit