Children rushed to the hospital after a knock on the noggin may wind up receiving a CT scan that they don’t need, exposing them to unnecessary doses of radiation.
As HealthDay News reports, that issue is raised by a study in the journal Pediatrics that reviewed more than 40,000 emergency room visits of children with symptoms of minor head trauma. In more than a third of those cases, the patient received a CT, or computerized tomography, scan, which delivers a significant jolt of radiation and raises the risk of cancer later in life.
But a key point that the researchers discovered was that when emergency room doctors kept the children for observation for four to six hours, they were somewhat more likely to skip a CT scan, and they were able to do so without compromising the quality of care. Of the patients who stayed for a full observation period, only 31.1 percent were scanned, versus 35 percent of the other patients.
What’s more, of the roughly 26,000 children overall who were discharged without a CT scan, only 107 later returned to the hospital for a scan, and of those, just one had a significant brain injury.
“CT scanning is a very powerful tool for ERs, but we have to be wiser as to which patient needs the neuro-imaging,” said Dr. Lisa E. Nigrovic, an author of the study and assistant professor of pediatrics at Harvard Medical School.
“We use CT scans for high-risk cases because we don’t want to miss a brain injury,” Nigrovic added. “But if a 3-year-old girl with a headache or vomiting can stay in the ER and be monitored, and if after four hours the symptoms are gone, that’s great. She can go home.”
Doctors aren’t certain of the precise cancer risk posed by additional CT scans, but they have observed a correlation between the two. A CT scan delivers 20 to 30 times the radiation that an X-ray does.
The median age of children in the study, which evaluated data from 25 U.S. emergency rooms, was 5.6 years.
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