Synopsis
Blunt head trauma is a common presentation in the pediatric ED. Although some children have overt signs of traumatic brain injuries (TBIs), many have minor head trauma with no or subtle signs of TBI. Among children with apparently minor blunt head trauma, identifying those who indeed have TBI is challenging. Over the past decade there has been increasing use of computed tomography (CT) to avoid missing children with TBI. This has resulted in overuse of CT, with resultant increased risks of radiation induced cancer. Dr. Kuppermann and colleagues have performed large-scale research to derive and validate clinical decision rules for appropriate use of CT in children with minor blunt head trauma. Dr. Kuppermann will discuss the results of a study to determine whether incorporating these CT decision rules into the electronic medical record system results in more appropriate use of CT. Finally, Dr. Kuppermann will discuss the process of shared decision-making with parents/patients when the decision to CT is not clear.
Speaker
Nathan Kuppermann, MD, MPH is Professor of Emergency Medicine and Pediatrics, and the Bo Tomas Brofeldt Endowed Chair of the Department of Emergency Medicine at UC Davis in Northern California. He is a pediatric emergency medicine (PEM) physician and clinical epidemiologist, and a leader in multicenter research. Research foci include 1) infectious emergencies in children including the laboratory evaluation of young febrile children, 2) the evaluation of children at risk of diabetic ketoacidosis-related cerebral injury, and 3) the laboratory and radiographic evaluation of the pediatric trauma patient. Dr. Kuppermann served as chair the US research network “PEM” (the Pediatric Emergency Medicine Collaborative Research Committee of the AAP) from 1996-2000, and was one of the founding investigators and chair of the Steering Committee of the Pediatric Emergency Care Applied Research Network (PECARN) since its inception in 2001. He is currently chair of the Executive Committee of the (global) Pediatric Emergency Research Network (PERN), an international consortium of PEM research networks.