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To determine if duration of emergency department (ED) observation affects rate of brain computed tomography (CT) utilization, investigators prospectively evaluated children (age, <18 years) presenting to a pediatric ED within 24 hours of minor blunt head trauma (Glasgow Coma Scale score of 14 or 15).
During 20 months, 1381 children (age, <2 years; 37%) were enrolled; 271 (20%) underwent CT and 676 (49%) were observed before CT decision making, at the discretion of the treating physician. The remainder were discharged home or had a CT scan immediately after evaluation. The overall odds of receiving a CT was 0.1 in children who were observed versus not observed.
In multivariate analysis, every hour of ED observation (median observation time, 2.…