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Head Trauma
Falls are the most common cause of injury in children younger than 15 years of age. Head trauma is the most common reason for admission to the hospital following an accident. CT has been the imaging modality of choice in evaluating the severity of head trauma in children and adults.
Until 2003, Medical Staff at Sparrow obtained a second CT scan of the head in most pediatric patients prior to discharge. The rational was to look for potential "interval changes".
After reviewing all the repeat scans, we found that in patients who were ready to be discharged based on physical examination, there were no new findings to change the decision to discharge. We then eliminated the second CT scan in August of 2003 and discharged patients based only on clinical evaluation and so far have not had to readmit any child who was discharged without a second CT.
This saves children exposure to radiation, extra time waiting for a test and the time required for the radiologist to read the study.
Potential useful information: about 120 pediatric patients are admitted each year to Sparrow with head injury. The majority of patients suffer mild head injury. The avarage length of stay is 1 and one half day. About 5% of patients will show deterioration after admission, they are usually defined as "moderate" and "severe" head trauma.
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