Pediatric head trauma algorithm for head CT decision-making in the emergency department
Abstract Background Traumatic brain injury is a common cause of admission in Emergency Department (ED) for pediatric patients. The aim of this study was to evaluate the application of the Pediatric Emergency Care Applied Research Network (PECARN) traumatic brain injury (TBI) algorithm in ED for head...
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BMC
2025-04-01
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| Series: | Journal of Anesthesia, Analgesia and Critical Care |
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| Online Access: | https://doi.org/10.1186/s44158-025-00238-x |
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| author | Gabriele Savioli Iride Francesca Ceresa Andrea Piccioni Yaroslava Longhitano Raymond Planinsic Michele Dorfsman Antonio Voza Federica Manzoni Giorgia Caputo Abdelouahab Bellou Luigi La Via Christian Zanza |
| author_facet | Gabriele Savioli Iride Francesca Ceresa Andrea Piccioni Yaroslava Longhitano Raymond Planinsic Michele Dorfsman Antonio Voza Federica Manzoni Giorgia Caputo Abdelouahab Bellou Luigi La Via Christian Zanza |
| author_sort | Gabriele Savioli |
| collection | DOAJ |
| description | Abstract Background Traumatic brain injury is a common cause of admission in Emergency Department (ED) for pediatric patients. The aim of this study was to evaluate the application of the Pediatric Emergency Care Applied Research Network (PECARN) traumatic brain injury (TBI) algorithm in ED for head CT decision-making in pediatric patients. The secondary objective was to evaluate the impact of adherence to this protocol on ED crowding, length of stay, and boarding time. Methods We conducted a retrospective study including children aged ≤ 15 years who were admitted in a level 2 trauma center ED for mild TBI from 1 January 2016 to 31 December 2019. Collected data included amnesia, symptoms, demographics, outcomes, length of ED stay, the patient’s outcomes, including intracranial injuries (ICI) and injuries requiring neurosurgery. Results A total of 1372 children with mild TBI were included. More than half of the patients were male (59.8%) and ≥ 2 years of age (63.2%). Most of the trauma events (58%) were caused by home injury. Neurosurgical consultation (59.4%) was the most common intervention in the ED. Only 4.3% of patients required neuroimaging and 7 children had intracranial hemorrhage, with only 1 requiring immediate neurosurgical intervention. There were no re-admissions for bleeding. The adoption of this protocol had no negative impact on crowding, and a reduction of ED length of stay. Conclusions The adoption of the PECARNE algorithm led to fewer brain computed tomography scans with good clinical outcomes without increasing crowding. |
| format | Article |
| id | doaj-art-5cd3430417a84a34adc05366c1e9f47a |
| institution | DOAJ |
| issn | 2731-3786 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Anesthesia, Analgesia and Critical Care |
| spelling | doaj-art-5cd3430417a84a34adc05366c1e9f47a2025-08-20T03:06:58ZengBMCJournal of Anesthesia, Analgesia and Critical Care2731-37862025-04-01511810.1186/s44158-025-00238-xPediatric head trauma algorithm for head CT decision-making in the emergency departmentGabriele Savioli0Iride Francesca Ceresa1Andrea Piccioni2Yaroslava Longhitano3Raymond Planinsic4Michele Dorfsman5Antonio Voza6Federica Manzoni7Giorgia Caputo8Abdelouahab Bellou9Luigi La Via10Christian Zanza11Department of Emergency Medicine, IRCCS Polyclinic San MatteoDepartment of Emergency Medicine, Public HospitalDepartment of Emergency Medicine, Foundation Agostino Gemelli Hospital, UCSCDepartment of Anesthesiology and Perioperative Medicine, University of PittsburghDepartment of Anesthesiology and Perioperative Medicine, University of PittsburghDepartment of Emergency Medicine, University of Pittsburgh Medical CenterDepartment of Emergency Medicine, Emergency Medicine Residency Program-Humanitas University HospitalHealth Promotion-Environmental Epidemiology Unit, Hygiene and Health Prevention Department, Health Protection AgencyDepartment of Anesthesia and Intensive Care, San Luigi Gonzaga HospitalInstitute of Sciences in Emergency Medicine, Department of Emergency Medicine, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical SciencesDepartment of Anesthesia and Intensive Care, University Hospital Policlinico “G. Rodolico–San Marco”Geriatric Medicine Residency Program, University of Rome “Tor Vergata”Abstract Background Traumatic brain injury is a common cause of admission in Emergency Department (ED) for pediatric patients. The aim of this study was to evaluate the application of the Pediatric Emergency Care Applied Research Network (PECARN) traumatic brain injury (TBI) algorithm in ED for head CT decision-making in pediatric patients. The secondary objective was to evaluate the impact of adherence to this protocol on ED crowding, length of stay, and boarding time. Methods We conducted a retrospective study including children aged ≤ 15 years who were admitted in a level 2 trauma center ED for mild TBI from 1 January 2016 to 31 December 2019. Collected data included amnesia, symptoms, demographics, outcomes, length of ED stay, the patient’s outcomes, including intracranial injuries (ICI) and injuries requiring neurosurgery. Results A total of 1372 children with mild TBI were included. More than half of the patients were male (59.8%) and ≥ 2 years of age (63.2%). Most of the trauma events (58%) were caused by home injury. Neurosurgical consultation (59.4%) was the most common intervention in the ED. Only 4.3% of patients required neuroimaging and 7 children had intracranial hemorrhage, with only 1 requiring immediate neurosurgical intervention. There were no re-admissions for bleeding. The adoption of this protocol had no negative impact on crowding, and a reduction of ED length of stay. Conclusions The adoption of the PECARNE algorithm led to fewer brain computed tomography scans with good clinical outcomes without increasing crowding.https://doi.org/10.1186/s44158-025-00238-xPediatric head traumaPECARN algorithmComputed tomographyEmergency department crowdingClinical decision rulesNeuroimaging protocols |
| spellingShingle | Gabriele Savioli Iride Francesca Ceresa Andrea Piccioni Yaroslava Longhitano Raymond Planinsic Michele Dorfsman Antonio Voza Federica Manzoni Giorgia Caputo Abdelouahab Bellou Luigi La Via Christian Zanza Pediatric head trauma algorithm for head CT decision-making in the emergency department Journal of Anesthesia, Analgesia and Critical Care Pediatric head trauma PECARN algorithm Computed tomography Emergency department crowding Clinical decision rules Neuroimaging protocols |
| title | Pediatric head trauma algorithm for head CT decision-making in the emergency department |
| title_full | Pediatric head trauma algorithm for head CT decision-making in the emergency department |
| title_fullStr | Pediatric head trauma algorithm for head CT decision-making in the emergency department |
| title_full_unstemmed | Pediatric head trauma algorithm for head CT decision-making in the emergency department |
| title_short | Pediatric head trauma algorithm for head CT decision-making in the emergency department |
| title_sort | pediatric head trauma algorithm for head ct decision making in the emergency department |
| topic | Pediatric head trauma PECARN algorithm Computed tomography Emergency department crowding Clinical decision rules Neuroimaging protocols |
| url | https://doi.org/10.1186/s44158-025-00238-x |
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