Adherence of Emergency Physicians to Pediatric Emergency Care Applied Research Network-Clinical Decision Rule (PECARN-CDR) in Minor Head Injuries Emergency Patients

Abstract

Introduction: Pediatric Emergency Care Applied Research Network (PECARN) is the best accurately identify children at very low risk of clinically important traumatic brain injuries (ciTBIs) in the Emergency Department (ED). Therefore, the implementation of evidence-based tools for clinical decision-making in the acute care setting has shown to improve quality of care as well as patients’ outcomes. This study aimed to assess the PECARN on quality of care in mild head injury children after improving competency of emergency physician. Methods: The study is a cross-sectional, prospective study included 50 Children with mild head trauma attending to the Emergency Department (ED) of the Suez Canal university Hospitals. Patients divided into two groups according to their age (less or more than 2 years). We used the Statistical Package of Social Science (SPSS) program version 20 for data analysis. Results: The most common cause of injury was direct head trauma, followed by motor car accidents and the least frequent injuries were due to fall from height. Our results regarding the adherence of residents to the PECARN CDR demonstrated that the residents were adherent largely to the rule with a level of adherence of about 92%. Conclusion: the adherence of the emergency department physicians in SCUH to the PECARN CDR while managing pediatric mild TBI. PECARN proved its effectiveness as a clinically predictive tool to understand who can safely avoid a cranial CT scan after TBI and the risk stratification provided by it was significantly associated with positive CT scan findings. Keywords: Pediatric care; Mild head injuries; Traumatic brain injuries