Computed Tomography Practice Standards for Severe Pediatric Traumatic Brain Injury in the Emergency Department: a National Survey
| Autor: | Tanya Holt, Rob Woods, Andrew Leach, Gregory Hansen, Gloria Ha Young Yoo |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
050103 clinical psychology
Resuscitation medicine.medical_specialty Respiratory rate Traumatic brain injury business.industry 05 social sciences Emergency department Critical Care and Intensive Care Medicine medicine.disease Blood pressure Knowledge translation Emergency medicine Heart rate Emergency Medicine medicine 0501 psychology and cognitive sciences Original Article business Adverse effect 050104 developmental & child psychology |
| Zdroj: | J Child Adolesc Trauma |
| ISSN: | 1936-1521 |
| Popis: | Acute medical management of traumatic brain injury (TBI) can be challenging outside of the resuscitation bay, specifically while obtaining a computed tomography (CT) scan of the brain. We sought out to determine the management practices of Canadian traumatologists for pediatric patients with severe TBI requiring CT in the emergency department (ED). In 2019, surveys were sent to trauma directors in hospitals across Canada to ascertain their clinical practices. Team members present in the CT scan included physicians (89%), registered nurses (100%), and respiratory therapists (38%). The average time to and from the CT scanner was one hour. Over half of respondents (56%) had experienced an adverse event in CT with variable access (11–56%) to necessary resuscitation equipment and medications. Significant hypotension (44%) was the most common adverse event experienced. With the exception of an end tidal CO(2) monitoring (56%), heart rate, rhythm, respiratory rate, saturation, and blood pressure were always monitored during a CT scan. Head of bed elevation had an approximately equal distribution of flat (44%) versus elevated (56%). The practice variability of Canadian traumatologists may reflect a lack of evidence to guide patient management. Future research and knowledge translation efforts are needed to optimize patient care during neuroimaging. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s40653-020-00317-x) contains supplementary material, which is available to authorized users. |
| Databáze: | OpenAIRE |
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