CME CREDIT NOW AVAILABLE-1.0 AMA PRA Category 1 Credit FOR EACH ISSUE (2 ARTICLES)!!!!!!

By Micheal Greenwald

mgreenw@emory.edu

Research continues on a number of fronts regarding head injury evaluation and management.  Below are highlights from 2 of these articles and a summary of a recently published set of guidelines from the CDC.  The articles were exceptionally large studies that pertain to important factors in deciding when to use CT in evaluation of head injury in children. The CDC guidelines explain levels of evidence for a variety of issues regarding diagnosis, prognosis management and treatment of concussion.

Vomiting as a predictor of intracranial injury¹

This large sampling (19, 920) of pediatric head injury patients in Australia and New Zealand (2011-14) looked at association of clinically important TBI (ciTBI) and vomiting.  This study supports previous research showing that vomiting is common following head injury, especially under 2 years of age; however, vomiting is rarely an independent predictor of ciTBI.

Patients with skull fractures, altered mental status, and headaches more likely to have ciTBI with vomiting (OR 80.1; 95% CI 43.4–148.0; OR 2.4; 95% CI 1.0–5.5; and OR 2.3; 95% CI 1.3–4.1, respectively).

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