Pediatric Head Trauma Guidelines for Pediatric Traumatic Brain Injury: Case
The Brain Trauma Foundation updated their guidelines for severe pediatric traumatic brain injury in 2019. To what degree do these guidelines replace the 2018 Advanced Life Support (ATLS) guidelines on all (mild and severe) traumatic pediatric brain injuries?
Today’s Guideline Knowledge Check question comes from the desk of Med-Challenger Emergency Medicine Editor-in-Chief, Andrea Eberly, MD, FAAEM.
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Try this review question and find out if you’re following the most current pediatric head trauma guidelines.
A 3-year-old girl presents to the emergency department (ED) after falling down 3 stairs.
She has a 2-cm hematoma on the forehead at the lateral prominence of the left supraorbital ridge.
She is awake and alert with a Glasgow Coma Scale (GCS) score of 15.
Although she is occasionally tearful, she is not agitated or slow to respond.
She has no history of loss of consciousness, vomiting, or severe headache.
On physical examination, her vital signs are normal, and she has no periorbital or mastoid ecchymosis, or hemotympanum.
Her fundi are difficult to examine, but appear normal.
Her neurologic examination is unremarkable.
Which of the following statements is true regarding the work-up and management of this patient’s head injury?
Computed tomography (CT) of the head is indicated.
The patient should be observed in the ED for 3 hours.
The patient should be admitted for 24 hours to undergo serial neurologic examinations.
The risk of clinically important traumatic brain injury (TBI) is low and the patient can be discharged home.
See the Answer:
About Guideline Knowledge Checks:
With each update of national clinical practice guidelines, some recommendations change and many remain unchanged. Med-Challenger Guideline Knowledge Checks help you know both what is new and what has stayed the same in the most recent guidelines pertinent to each medical specialty.
About the Author:
Andrea Eberly, MD, FAAEM graduated from the David Geffen Medical School of Los Angeles (UCLA) and completed her residency in Emergency Medicine at the University Medical Center, Tucson, Arizona. After working as an attending physician in Tucson, she followed a recruiting call to the island of Guam, where she served in various roles, including as the director of the emergency department, the EMS Medical Director of Guam, and the Director of the 911 Call System. She has maintained her emergency medicine board certification through three cycles of American Board of Emergency Medicine Board Exams (last in 2014), all three with the help of Med-Challenger.
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