BMJ  2006;333:455-456 (2 September), doi:10.1136/bmj.38954.516933.DE

Editorial

Managing minor head injury in children

Early discharge after computed tomography is safe and cost effective

The first 150 words of the full text of this article appear below.

In the United Kingdom some 500 000 children attend accident and emergency departments after a head injury and about 50 000 are admitted (nearly 10% of all hospital admissions). The death rate is 5.3 per 100 000 children.¹ Despite various guidelines on the management of head injury, clinical practice varies. Two papers in this week's BMJ shed new light on the management of mild head injury in children admitted to emergency departments.^{2 3} They compare immediate computed tomography for triage with inpatient observation in mild head injury—920 of the 2602 enrolled patients were aged 6-15. No child died or needed surgical intervention. Early discharge after immediate computed tomography was no worse in terms of recovery at three months, later complications, and patient satisfaction; it was also less costly than inpatient observation.

Here is a scenario familiar to emergency department doctors, paediatricians, and general practitioners. A child suffers apparently mild head . . . [Full text of this article]

BMJ Editorial, Tavistock Square, London WC1H 9JR
(h.marcovitch@btinternet.com)

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    StumbleUpon    Technorati    What's this?

Relevant Articles

Immediate computed tomography or admission for observation after mild head injury: cost comparison in randomised controlled trial

Anders Norlund, Lars-Åke Marké, Jean-Luc af Geijerstam, Sven Oredsson, Mona Britton OCTOPUS Study
BMJ 2006 333: 469. [Abstract] [Full Text] [PDF]

Medical outcome after immediate computed tomography or admission for observation in patients with mild head injury: randomised controlled trial

Jean-Luc af Geijerstam, Sven Oredsson, Mona Britton OCTOPUS Study Investigators
BMJ 2006 333: 465. [Abstract] [Full Text] [PDF]

This article has been cited by other articles:

• Smits, M., Hunink, M.G.M., van Rijssel, D.A., Dekker, H.M., Vos, P.E., Kool, D.R., Nederkoorn, P.J., Hofman, P.A.M., Twijnstra, A., Tanghe, H.L.J., Dippel, D.W.J. (2008). Outcome after Complicated Minor Head Injury. Am. J. Neuroradiol. 29: 506-513 [Abstract] [Full text]  
• (2006). Triaging Patients with Minor Head Injury. JWatch General 2006: 3-3 [Full text]  

Rapid Responses:

Read all Rapid Responses

Managing minor head injury in children

Alan M Leaman
bmj.com, 2 Sep 2006 [Full text]

Radiology response

Richard M Wellings
bmj.com, 3 Sep 2006 [Full text]

Misleading picture

Robert M Bethune
bmj.com, 7 Sep 2006 [Full text]

It isn't always all on the CT!

Barbara J Boucher
bmj.com, 6 Dec 2006 [Full text]

Online poll

Find out more here>> and here>>