Emergency Physicians’ Approach to Minor Head Trauma in Pediatric Patients
Abstract
Objectives: To investigate the use of tomography in children with head trauma by emergency department physicians, the frequency of their
applying clinical decision-making rules (CDMRs), and the factors playing a role in the decision of tomography use.
Materials and Methods: Our 19 question-survey was applied to physicians working in different statuses in the emergency departments of various
hospitals in our country.
Results: Three hundred and six physicians participated in our study. The rate of tomography use in pediatric patients with minor head trauma was
reported by physicians as follows: One hundred and three physicians stated as 10% or less, 60 as between 11% and 25%, 39 as between 26% and
50%, and 104 as 50% or more. 39.5% of the participants stated that they applied CDMRs when making a computed tomography (CT) decision,
42.8% stated that they decided according to their clinical experience, 6.2% stated that they made the decision with the recommendation of a
consultant. 36.6% of the physicians stated that they were threatened and insulted for not performing a CT scan and 6.9% stated that they were
subjected to verbal and physical attacks. The reason for the increase in tomography use was defined as the fear of malpractice by 56.2%, family
pressure by 22.2% and desire to conclude the patients quickly in a busy working environment by 8.2% participants.
Conclusion: It was observed that the rate of application of CDMRs by physicians was low and the rate of tomography use was high. Medico-legal
concerns, the pressure of families, and patient overcrowdedness in the emergency room took the top three places among the reasons for this.
Keywords
Emergency Department, Computerized Tomography, Pediatric Head Trauma, Clinical Decision-Making Rules
Ethical Statement
Ethical approval was obtained
from Kahramanmaraş Sütçü İmam University Faculty of
Medicine Clinical Research Ethics Committee
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