For the remainder of patients in the nebulous undefined area of risk, the best test is time, which is radiation-free and inexpensive.
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ACEP Now: Vol 38 – No 02 – February 2019The opinions expressed here are solely those of Dr. Radecki and do not necessarily reflect those of his employer or academic affiliates.
References
- Kuppermann N, Holmes JF, Dayan PS, et al. Identification of children at very low risk of clinically-important brain injuries after head trauma: a prospective cohort study. Lancet. 2009;374(9696):1160-1170.
- Dunning J, Daly JP, Lomas JP, et al. Derivation of the children’s head injury algorithm for the prediction of important clinical events decision rule for head injury in children. Arch Dis Child. 2006;91(11):885-891.
- Osmond MH, Klassen TP, Wells GA, et al. CATCH: a clinical decision rule for the use of computed tomography in children with minor head injury. CMAJ. 2010;182(4):341-348.
- Radecki RP. Published clinical decision aids may lack validation. ACEP Now. 2018;37(2):26-28.
- Babl FE, Borland ML, Phillips N, et al. Accuracy of PECARN, CATCH, and CHALICE head injury decision rules in children: a prospective cohort study. Lancet. 2017;389(10087):2393-2402.
- Babl FE, Oakley E, Dalziel SR, et al. Accuracy of clinician practice compared with three head injury decision rules in children: a prospective cohort study. Ann Emerg Med. 2018;71(6):703-710.
- Davey K, Saul T, Russel G, et al. Application of the Canadian computed tomography head rule to patients with minimal head injury. Ann Emerg Med. 2018;72(4):342-350.
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