Brian H Rowe, clinician scientist12, Esther Yang, research assistant13, Shaina Corrick, graduate student1, M Wasif Hussain, clinician scientist41Department of Emergency Medicine, Faculty of Medicine & Dentistry, College of Health Sciences, University of Alberta, Edmonton, Alberta, Canada2School of Public Health, College of Health Science, University of Alberta3SPOR SUPPORT Unit, Alberta Health Services (AHS), Edmonton4Department of Medicine, Division of Neurology, Faculty of Medicine & Dentistry, College of Health Sciences, University of AlbertaCorrespondence to: B H Rowe brian.rowe{at}ualberta.caWhat you need to know
Non-contrast computed tomography (CT) for minor traumatic brain injury (mTBI) is often ordered, rarely provides positive results, and is associated with increased risk of patient harm and increased healthcare costs
Several valid and reliable clinical decision rules (CDRs) have been developed to determine whether a CT scan of the head is indicated
Evidence from implementation research shows that a strategy of using a CDR can safely, albeit modestly, decrease the use of CT scans in adult patients with mTBI
Non-contrast computed tomography (CT) is an important imaging modality in the care of adult patients with acute medical problems and injuries in an emergency department. These images can initiate timely and lifesaving interventions. One area where the utility of CT scanning has been debated is after minor traumatic brain injury (mTBI) or concussion in adults. This condition is defined as a direct blow to the head, neck, or body resulting in impulsive forces being transmitted to the brain causing alteration in mental status, with symptoms developing immediately or over time, that may include a loss of consciousness.1 Common mechanisms include sports and recreational activities, falls, motor vehicle crashes, and physical assault.2 In most clinical presentations of mTBI, the neurological examination is normal and the Glasgow Coma Scale (GCS) is 13-15. GCS
According to a CDC report, fewer than 10% of adult patients in the US experiencing a mTBI suffer serious brain injuries that require hospitalisation or surgery, and most are discharged from the emergency department based on clinical assessment alone.3 A prospective study of patients with minor head injuries in Canada found that 5% had clinically important brain injuries and 0.4% required neurosurgical intervention. Similarly, a US study of patients with minor head injuries seen in emergency departments found that 3.5% had …
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Publish date : 2024-08-12 23:42:00
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