Think your kid has a brain injury? Observe first, then x-ray

Kids in New York commonly hit their heads – falling out of trees, off of swings and tripping over obstacles. Now, a new study published in Pediatrics tells doctors that not every child who has a bump on his or her head requires immediate x-rays. Researchers have found that longer observation of children can avoid unnecessary scans for brain injuries.

Because doctors don’t know if radiation exposure during repeated computed tomography or CT scans will affect a child’s health later in life, the study suggests that doctors should wait until symptoms warrant an x-ray. By observing children, rather than automatically ordering a CT scan, doctors may be able to better determine whether injured kids really need scans.

The data for the study of 40,000 children with head injuries was first compiled by the Pediatric Emergency Care Applied Research Network and later reviewed by study authors. The manner in which doctors treated children who had head injuries was studied.

The research found that doctors who observed children in the hospital or asked parents to monitor the child at home before making a decision about taking a CT scan opted for the x-ray fewer times than doctors who did not wait and observe. Only one out of about 100 children in the study had serious brain injuries.

Researchers say the study reflects the way in which doctors already treat head-injury patients. Some scan right away, others send kids home and ask parents to check if there are any changes, and others admit children to the hospital to be monitored. Study analysts say observing children before scans may be most beneficial to the children’s health in the long-run because it will minimize uncertain radiation exposure.

Source: Reuters Health, “A little waiting may be good for head-injured kids,” Genevra Pittman, 9 May 2011