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1- Department of Emergency Medicine, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
2- Department of Emergency Medicine, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
3- Department of Emergency Medicine, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran. , hariri.shahram@gmail.com
Abstract:   (410 Views)
Context: The current review article considered the latest published papers on reducing unnecessary head computed tomography (CT) scans in pediatrics, so that a better basic structure can be made for further surveys.
Evidence acquisition: The papers were selected using Google scholar and Pubmed to search “reducing unnecessary head CT scan in pediatrics” with related keywords compatible with Mesh system in search strategy. Original articles and systematic reviews published after 2010 were included; but other types of manuscripts such letter to editor, editorial, case series, etc. were excluded. The eligible articles’ title and abstract were assessed for relevance to our topic. The full-text of final selected papers were studied by the investigators. Furthermore, a critical appraisal was performed in an expert panel to summarize and make it applicable.
Results: The extracted manuscripts have addressed this issue with various strategies. To simplify discussion, the findings could be categorized as followed: observation period, focused history taking; protocol and guideline development; implementation of validated clinical prediction rules; and finally blood-based decision making by assessing neuro-biomarkers level.
Conclusion: Most of reviewed articles are focused on clinical findings so that we can find the very low risk or low risk category of the pediatrics with blunt head trauma. Some other also tried to ease the use of available clinical prediction rules in this regards. On the other hand, measurement of serum biomarkers level have been taken into account, but their widely application in practice is not well supported by evidence yet.
Full-Text [PDF 634 kb]   (111 Downloads)    
Type of Study: Narrative Review | Subject: Pediatric Neurology
Received: 2018/01/28 | Accepted: 2018/05/29 | Published: 2018/06/11