Emerg Med J 30:166-167 doi:10.1136/emermed-2012-202190.4
  • Best Evidence Topic reports

BET 3: Management of paediatric minor head injuries: safe discharge?

Report by: Dr Fiona Hunter, ST4 Emergency Medicine

Search checked by: Dr Vincent Choudhery, Consultant in Paediatric Emergency Medicine

Institution: Yorkhill Hospital, Glasgow, UK


A short-cut review was carried out to establish whether the finding of a normal cranial CT scan, in a child with a history of minor head injury, a Glasgow coma scale (GCS) score of 15 and normal neurological examination could facilitate safe discharge from hospital. Ninety-eight articles were found using the reported search and a further two papers were found from the references of selected papers. A total of 11 trials were included with one prospective cohort study including 13 543 patients. The authors, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these papers are tabulated (table 3). It is concluded that in the absence of any coagulation problems, a child who presents following a minor head injury with a GCS of 15, normal neurological examination and a normal CT scan can be safely discharged to the care of …

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Among patients with minor TBI (GCS 13-15) getting CT scans ≥ 24 hours after injury, what proportion have a traumatic finding?


0.5% - 43% response rate
3% - 41% response rate
10% - 16% response rate

Related original article: PCT head imaging in patients with head injury who present after 24 h of injury: a retrospective cohort study

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