Experts have created new clinical guidelines to diagnose and manage mild to moderate head injuries in children. 

The new guidelines are aimed at enabling emergency department clinicians to diagnose and treat children’s head injuries while also reducing unnecessary exposure to radiation from CT scans. 

They are the first such protocols to be developed specifically for Australia and New Zealand. 

Head injury is one of the most common reasons for children to present to emergency departments.

In Australia and New Zealand about 10 per cent of children who present with head injuries of all severities have CT scans. Despite traumatic brain injuries being uncommon, persistent post-concussive symptoms affect more than a third.

“While we need to rule out any bleeding in the brain, we don’t want to order CT scans unnecessarily, because it increases children’s lifetime radiation exposure,” said one of the leaders of the research project, Professor Franz Babl.

“The lack of standardised guidelines meant children were receiving different care depending on where they were seen. Widespread uptake of these guidelines will change that.”

The new guidelines are based on extensive search and assessment of international guidelines such as those used in Canada, the US and the UK. 

The working group developed 71 recommendations and an imaging/observation algorithm relevant to the Australian and New Zealand setting. The new guidelines cover patient triage, imaging, observation versus admission, transfer, discharge and follow-up.

The PREDICT working group who developed the guidelines included emergency physicians, pediatricians, neurologists, neurosurgeons, radiologists, sports medicine doctors, neuropsychologists, GPs, paramedics and nurses.

The guidelines are accessible here.