Pediatric Minor Head Injury: Agreement Between Nurse and Physician Risk Assessments

In a prospective observational study of children presenting to a pediatric emergency department for minor head trauma (Glasgow Coma Scale score, 14 or 15), investigators determined the level of agreement between nurses and physicians in evaluating risk for clinically important brain injuries, as determined by the Pediatric Emergency Care Applied Research Network's (PECARN's) clinical prediction rules (see table).

During 20 months, 81 emergency nurses and 98 physicians (emergency medicine attendings, pediatric emergency medicine fellows, and pediatricians) evaluated 1191 children with acute minor head injuries. All paired assessments were completed within 60 minutes of each other (median, 12 minutes). Of 598 children classified by the nurse a…