Keywords:
Emergency, CT, Audit and standards, Decision analysis, Outcomes analysis, Acute, Trauma
Authors:
Z. Vajuhudeen; Mackay, QLD/AU
DOI:
10.26044/ranzcr2021/R-0430
Methods and materials
Background
Approximately 150 in 100,000 Australians present to the Emergency Department (ED) with a closed head injury [1]. Approximately 80% of these cases are categorised as minor [2].
For low-risk patients without obvious signs of brain injury, the need for neuroimaging can often be avoided. However, this is not always practised as CT imaging is becoming increasingly ubiquitous.
The Canadian CT Head Rule (CCHR) attempts to address this issue. It is a well-validated tool used to identify those patients presenting with a minor head injury that should undergo a CT scan only if they meet one or more of its high-risk criteria, and may require a CT scan if they meet one or more of its medium-risk criteria [3].
The Choosing Wisely Australia campaign, in conjunction with the Royal Australian and New Zealand College of Radiologists (RANZCR), supports the use of the CCHR in this clinical setting [4].
Methods
All CT head requests made for patients treated at a single-site regional Emergency Department of a medium-sized hospital in Queensland over a 3 month period (May to July 2020) were obtained (n = 926).
From this data, adults (≥ 16 years) who had presented with a head injury secondary to blunt trauma (n = 273) were selected for analysis.
The CCHR exclusion criteria was then used to remove a further 97 patients that were deemed ineligible.