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Reducing unnecessary CT scan of the head for minor paediatric head injuries at the emergency department
  1. Amr Elmoheen,
  2. Waleed Salem,
  3. Khalid Bashir
  1. Emergency Medicine, Hamad Medical Corporation, Doha, Qatar
  1. Correspondence to Dr Amr Elmoheen; aelmoheen{at}hamad.qa

Abstract

The CT scan is a determining imaging study in the diagnosis and treatment of head trauma; however, its indiscriminate application can have serious consequences for patients and the health system. More than 45% of CT scans of the head requested for minor head injuries in the paediatric age group in the emergency department were not correctly indicated according to international guidelines. The root of such a high percentage was misinformation and lack of knowledge about the ideal parameters for requesting a CT scan for minor head injuries. To achieve this, survey-based interventions and educational programmes were conducted to improve understanding of international guidelines and access to this information, which was the most important parameter during this project. A decreasing rate of CT scans for paediatric minor head injuries was demonstrated at the rate of 17%, achieving a reduction by more than 47% after the implementation of the interventions. Besides, misinformation and documentation deficits improved by more than 30%. Quality improvement methods decreased misinformation and improved access to information, which reduced errors in the indication of CT scans of the head in the paediatric age group and increased efficiency of patient care.

  • emergency department
  • paediatrics
  • evidence-based practice
  • PDSA
  • quality improvement
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This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

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Footnotes

  • Twitter @amamiro2000

  • Collaborators Saleem Farouk and Stephen Thomas.

  • Contributors AE planned and conducted the project, designed the management algorithm, did the literature review and wrote the manuscript. WS conducted a survey, delivered staff education, performed data collection and reviewed the manuscript. KB reviewed the manuscript and supervised the project.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available upon request.