The PECARN Head CT Decision Rule in a Community ED

After implementation of the rule, CT use and length of stay both decreased, while return visits within 72 hours remained unchanged.

The Pediatric Emergency Care Applied Research Network (PECARN) head injury decision rule, first published in 2009, risk stratifies children with head injury to determine whether they might safely avoid head computed tomography (CT) imaging. Since then, the decision rule has been validated (NEJM JW Emerg Med Sep 2012 and Acad Emerg Med 2012; 19:801) and shown to have good inter-rater reliability (NEJM JW Emerg Med Dec 2013 and Pediatrics 2013; 132:e689). However, use of head CT in children with closed head injuries has not changed in the U.S. (NEJM JW Emerg Med Dec 2018 and Pediatr Emerg Care 2018 Sep 25; [e-pub]). This may be because most children with these injuries are first seen in community emergency departments (EDs) rather than pediat…

Reviewing Author

Ali S. Raja, MD, MBA, MPH

Disclosures

Leadership Positions in Professional SocietiesSociety for Academic Emergency Medicine (Board Member); American College of Healthcare Executives – Massachusetts (Board Member)

Ali S. Raja, MD, MBA, MPH

Disclosures

Leadership Positions in Professional SocietiesSociety for Academic Emergency Medicine (Board Member); American College of Healthcare Executives – Massachusetts (Board Member)

The PECARN Head CT Decision Rule in a Community ED

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Reviewing Author