An Effective Initiative to Reduce Head CT in Children with Minor Blunt Head Trauma

Investigators studied the effect of a quality-improvement effort to reduce cranial computed tomography (CT) rates by 10% in children (≤21 years of age) presenting to a tertiary pediatric emergency department (ED) with minor blunt head trauma. The initiative involved a guideline based on the Pediatric Emergency Care Applied Research Network's low-risk age-based predictors for traumatic brain injury, in combination with clinical observation, to determine need for cranial CT (NEJM JW Emerg Med Oct 2009 and Lancet 2009 Sep 15; [epub]). The guideline recommended immediate CT for children with either a single high-risk predictor (altered mental status or signs of skull fracture) or three or more other predictors; a period of observation before CT…