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It may make more sense to observe children in the ER before rushing to perform a CT scan, but how long do you wait before making a decision to perform a CT scan?

When to perform a CT scan on a child in the emergency room following head trauma is a complicated decision.  Observing some children after a head injury may help reveal which ones need a computed tomography (CT) scan and which ones don't, enabling many to avoid the radiation of an unnecessary test, according to a recent study.

A negative CT scan does not mean that a concussion or brain injury has not taken place and needless CT scans can be avoided by taking the time to observe children in emergency rooms.   

One of the study authors, Lise Nigrovic at Children's Hospital, Boston, told Reuters Health News that if a child shows up at an emergency room very soon after a head injury, "you may just not have had enough time for symptoms to develop".

Nigrovic and her colleagues reviewed data on over 40,000 children with a head injury who were taken to one of 25 different emergency rooms.

The original data had been collected by the Pediatric Emergency Care Applied Research Network, with chart notes showing whether each child was admitted for observation before doctors decided whether or not to perform a CT scan.

The researchers concluded that observing some children before making the decision about a CT scan might be a safe and effective way of cutting back on scans, giving the example of a child who fell off a swing, had a headache and vomited once, but were awake and talking two hours after the injury.



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