Abstract
Minor head injury (MHT) is one of the most common causes of all trauma admissions and it is still controversial to manage adequately. Although the incidence of clinically significant traumatic brain injury is low in this group, the consequences of missing clinically important problem are potentially life threatening. Early diagnosis of intracranial hematoma by computed tomography scan (CT) followed by early surgery is very important in the treatment of such patients. Thus, there has been a tendency to use high levels of diagnostic imaging in these conditions. There are many decision rules for the use of computed tomography (CT) for patients with minor head injury. This survey is to determine the awareness and utilization rates of these head CT rules among our emergency physicians (EP). Questionnaire was randomly sent to EPs from different ministry of health hospitals in Makkah. Our participants were asked about their awareness of such rules and their applications in their careers. Data were collected and analyzed by SPSS V16.0. The awareness and utilization rate of clinical decision rules among 91 ER physicians who responded were 54.4% and 42.2% respectively. The barriers to utilize such rules were the working environment and increased chances of getting lawsuits, which were 55.4% and 61.7% respectively. 91.1% of those physicians would like to receive guidance on how to apply such rules in their daily practices. There is a misunderstanding of the definition of minor head injury, despite the high number of head traumas, which led to request more CT scan. This will be a burden on the healthcare system and will lead to more radiation exposure. More educations regarding head CT rules will result in better utilizing of our resources and reduction in radiation risks.
Highlights
An estimated 1.7 million people sustain a Traumatic Brain Injury (TBI) annually are seen in the United States’ emergency rooms and 80% of them are classified as minimal or minor head injury where they are treated and released from an emergency department [1]
This will be a burden on the healthcare system and will lead to more radiation exposure
The total study sample was 91 physicians working in ED. 76.92% of them were male (70) physicians of an age ranging from 28 - 55 years with a mean and standard deviation (SD) of 40.54 ± 8.94
Summary
CT scan is an integral rule to triage and manage patients with traumatic head injury because the consequences of missing a clinically important problem are potentially life threatening. In 10 large Canadian hospitals, the use of CT scan has increased 165%, from 30% to 80%, especially for minor head injury patients [1]-[9]. Studies and articles which have strongly suggested that all patients with minor head injury should undergo CT scan; it would eventually leads to a greater than 300% increase in the use of CT scan for Canadian and European patients with minor head injury [2]. This study aims to measure the emergency physicians’ awareness toward indications of CT scanning in TBI according to CCHR and/or NOC by using a designed questionnaire with a short clinical scenario
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