Application of the Canadian Computed Tomography Head Rule to Patients With Minimal Head Injury

Annals of Emergency Medicine
Kevin DaveyJoshua Quaas

Abstract

Two clinical decision rules, the Canadian CT Head Rule and the New Orleans Criteria, set the standard to guide clinicians in determining which patients with minor head trauma need computed tomography (CT) imaging. Both rules were derived with patients with minor head injury who had had a loss of consciousness or witnessed disorientation. No evidence exists for evaluating patients and need for CT imaging with minimal head injury; that is, patients who had a head injury but no loss of consciousness or disorientation and therefore would have been excluded from the Canadian CT Head Rule and New Orleans Criteria trials. We evaluate the Canadian CT Head Rule in patients with head injury without loss of consciousness or witnessed disorientation (minimal head injury). We studied a prospective convenience sample of patients with minimal head injury who received head CTs as part of their evaluations in the emergency department (ED). Participants were enrolled after head CT was ordered, but before the physician received the imaging results. Physicians were surveyed on their clinical reasoning for ordering imaging in this low-risk cohort of patients. Physicians surveyed consisted of ED attending physicians and senior-level emergency medici...Continue Reading

Citations

Jun 23, 2019·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·Jesse M Pines
Sep 16, 2020·BMC Emergency Medicine·Maria Louise GamborgPeter Musaeus
May 8, 2021·Journal of the American College of Radiology : JACR·UNKNOWN Expert Panel on Neurological ImagingAmanda S Corey

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