Investigation of Emergency Physicians' Compliance With Computed Tomography Rules in Pediatric Patients With Head Trauma

Year 2025, Volume: 1 Issue: 2, 77 - 82, 01.09.2025

Gültekin Akyol , Selma Atay İslam , Hande Akbal Kahraman , Muhammed Fatih Cırıl , İsmail Tayfur

Abstract

Objective: We aimed to analyse the tendency of emergency physicians to order brain computed tomography in paediatric patients admitted to the emergency department with head trauma and their level of knowledge about the PECARN algorithm.
Materials and Methods: A survey was conducted among emergency medicine specialists and emergency medicine assistants who worked in emergency departments where paediatric trauma patients were admitted between January 2021 and January 2023.
Results: A total of 204 out of 450 emergency medicine specialists and emergency medicine residents working in Istanbul participated in our survey study. 138 (68.3%) participants stated that the decision to perform brain CT was based on physician's prediction and 64 (31.7%) participants stated that it was based on PECARN rules.
The median clinical experience of physicians working in the emergency department of a tertiary care hospital was calculated as 5 (3- 9) years, while the median clinical experience of physicians working in the emergency department of a secondary care hospital was calculated as 8 (5 - 14) years, and the difference was statistically significant (p<0.001).
When the responses of the physicians working in the emergency departments of tertiary and secondary care hospitals to the questionnaire questions were compared, a difference was observed in the question "I would have a tomography if the patient has a headache that worsens after 2 hours of observation" (p=0.005).The difference was seen to be caused by the "agree" and "disagree" responses to this question. 94.3% of the physicians working in the emergency department of a tertiary care hospital and 81.3% of the physicians working in the emergency department of a secondary care hospital agreed with this question (p=0.016).
Conclusion: We observed that age or clinical experience did not play a role in adherence to PECARN. We concluded that both groups did not adhere to PECARN, whether they stated that they adhered to PECARN or not. We think that periodic and systematic training should be provided for the PECARN scoring system, which provides important guidance in patient diagnosis and follow-up.

Keywords

Head Trauma , Paediatric Patient , PECARN , Emergency Physician

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