Planned Observation Safely Reduces CT Use in Children with Mild Traumatic Brain Injury

Planned observation for children with minor head injury has been shown to decrease computed tomography (CT) use in North America, where CT rates are high (NEJM JW Emerg Med Jul 2011 and Pediatrics 2011; 127:1067). These authors tested the effect of observation on CT use in 10 pediatric emergency departments (EDs) in Australia and New Zealand, where CT rates are already low.

The authors conducted a secondary analysis of a 2011–2014 prospective observational study of children (age <18 years) with blunt traumatic brain injury (TBI) and Glasgow Coma Scale (GCS) scores of 14–15. They compared patients who underwent planned observation (n=4945) to those for whom the decision to scan (or not scan) was made immediately (n=13,526), with stratificatio…