Application of the 2007 NICE guidelines in the management of paediatric minor head injuries in a UK emergency department

Background The National Institute for Health and Clinical Excellence (NICE) published guidelines containing clear criteria for CT scanning of children with head injury in 2007. The aim of this study was to quantify the effects of adherence to these guidelines on the number of head scans requested. Method A retrospective case note review was carried out of all patients under the age of 16 years presenting to the emergency department with head injury in 2007. The number of CT head scans actually performed was recorded, and the number that would have been requested using the hospital guidelines and the 2007 NICE guidelines was calculated. Results 25 (6.7%) of the 394 patients included in our study had head CT scans. 47 (12.7%) children would have been scanned had the hospital guidelines been rigidly followed and 74 (19.7%) children would have had head CT scans if the 2007 NICE guidelines had been adhered to. Conclusion Considerably fewer children with head injury had CT scans in 2007 than would have been indicated by the hospital guidelines or 2007 NICE guidelines.