I am biased – I helped set the Pediatric Emergency Care Applied Research Network up back as a research assistant peon before medical school – so it always pleases me to report on PECARN’s newest outputs.
This is a preplanned sub-analysis of their massive observational pediatric blunt trauma study. Their pediatric blunt trauma decision instrument, unfortunately, turned out to not be terribly useful. This data on the outcomes of patients with negative abdominal CT scans, at least, ought to help us.
Of the 3,819 patients enrolled with normal abdominal CTs following blunt trauma, 6 went on to have clinically significant abdominal injuries requiring intervention. They provide a lot of detail about the patient population, but their conclusion is pretty simple: don’t routinely admit these trauma patients for observation to try and catch that 0.02%. If there’s no other indication for admission, they may be discharged with appropriate symptom return precautions.
“A Multicenter Study of the Risk of Intra-Abdominal Injury in Children After Normal Abdominal Computed Tomography Scan Results in the Emergency Department”
www.ncbi.nlm.nih.gov/pubmed/23622949