31 A new paediatric head injury assessment tool considering subject-specific child head anatomy

Author(s):  
Jingwen Hu ◽  
Alexander Rogers ◽  
Byoung-Keon Park
2020 ◽  
Vol 37 (12) ◽  
pp. 853-854
Author(s):  
Patrick Aldridge ◽  
Heather Castle ◽  
Emma Russell ◽  
Clare Phillips ◽  
Richard Guerrero-Luduena ◽  
...  

Aims/Objectives/BackgroundObjectivesTo assess if application of a nurse-led paediatric head injury clinical decision tool would be safe compared to current practice.Background>700,000 children attend UK hospitals’ each year with a head injury. Research indicates <1% undergo neurosurgical intervention. No published evidence for nurse-led discharge of paediatric head injuries exists.Methods/DesignMethods – All paediatric (<17 years) patients with head injuries presenting to our Emergency department (ED) 1st May to 31st October 2018 were prospectively screened by a nurse using a mandated electronic ‘Head Injury Discharge At Triage’ questionnaire (HIDATq). We determined which patients underwent computed tomography (CT) brain and whether there was a clinically important intracranial injury or re-presentation to ED. The negative predictive value of the screening tool was assessed. We determined what proportion of patients could have been sent home from triage using HIDATq.Results/ConclusionsResults - Of 1739 patients screened; 61 had CTs performed due to head injury (6 abnormal) with a CT rate of 3.5% and 2% re-presentations. Of the entire cohort, 1052 screened negative. 1 CT occurred in this group showing no abnormalities. Of those screened negative: 349/1052 (33%) had ‘no other injuries’ and 543/1052 (52%) had ‘abrasions or lacerations’. HIDATq’s negative predictive value for CT was 99.9% (95% Confidence interval (CI) 99.4–99.9%) and 100% (CI 99.0–100%) for intracranial injury. The positive predictive value of the tool was low. Five patients screened negative and re-presented within 72hrs but did not require CT imaging.Conclusion - A negative HIDATq appears safe in our ED. Potentially 20% (349/1739) of all patients with head injuries presenting to our department could be discharged by nurses at triage with adequate safety netting advice. This increases to 50% (543/1739) if patients with lacerations or abrasions were treated and discharged at triage. A large multi-centre study is required to validate the tool.


Brain ◽  
2001 ◽  
Vol 124 (7) ◽  
pp. 1261-1262 ◽  
Author(s):  
D. I. Graham

Author(s):  
Sonia Singh ◽  
Franz E Babl ◽  
Stephen J C Hearps ◽  
Jeffrey S Hoch ◽  
Kim Dalziel ◽  
...  

2011 ◽  
Author(s):  
Jeffrey T. Somers ◽  
Bradley Granderson ◽  
John W. Melvin ◽  
Ala Tabiei ◽  
Charles Lawrence ◽  
...  

2021 ◽  
Author(s):  
Andrew J Gardner ◽  
Grant Iverson ◽  
Suzi Edwards ◽  
Ross Tucker

Abstract Background The tackle is the in-game activity carrying the greatest risk for concussion in Rugby. A recent evaluation of tackle characteristics in Rugby Union precipitated a rule modification to reduce head impact risk during tackles. This study aims to replicate the work conducted in Rugby Union by examining the association between tackle characteristics and head injury events in professional Rugby League. Methods We reviewed and coded 446 tackles resulting in a head injury assessment (HIA) and 5,694 tackles that did not result in a head injury from two National Rugby League (NRL) seasons. Tackle height, body position of players, and contact area on an opponent’s body were evaluated, with the propensity of each situation to cause an HIA calculated as HIAs per 1000 events. Results The propensity for tacklers to sustain a head injury was 0.99 HIAs per 1000 tackles, 1.74-fold greater than for the ball carrier (0.57 HIAs per 1,000 tackles). There was a 3.2-fold higher risk for an HIA when the tackler was upright compared to bent-at-the-waist. The greatest risk of a tackler HIA occurred when head contact was very low (knee, boot) or high (head and elbow). HIAs were most common following head-to-head impacts. The lowest propensity for tackler HIA was found when the tackler’s head was in proximity with the ball carrier’s torso. Conclusions The result of this study replicated the findings in professional rugby union. This has implications for the injury prevention initiatives implemented to reduce HIA risk because the majority of injuries are sustained by the player initiating the action.


2005 ◽  
Vol 28 (3) ◽  
pp. 163-167 ◽  
Author(s):  
Jafri Malin Abdullah ◽  
Naziah Awang ◽  
Mazira Mohamad Ghazali ◽  
Narasappa Kumaraswamy ◽  
Mohd Rusli Abdullah

2018 ◽  
Vol 37 (3) ◽  
pp. 262-267 ◽  
Author(s):  
Gregory J Tierney ◽  
Karl Denvir ◽  
Garreth Farrell ◽  
Ciaran K Simms

Author(s):  
Janis Whitlock ◽  
Deinera Exner-Cortens ◽  
Amanda Purington

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