Clinical audit on the use of radiography in the management of pediatric head trauma

Objectives: Implementation of a diagnostic protocol, developed after consensus and adapted to the local setting, could reduce the frequency of radiography in the management of pediatric head injury and could improve healthcare quality and resource utilization. Patients and method: A clinical audit, with two 12-month phases, before and after the implementation of a diagnostic protocol, was performed. The audit was based on a literature review and was adapted to local conditions. Results: After the implementation of the protocol, the use of skull radiography decreased from 45.8% to 38.9% and inappropriate use fell from 25.1% to 14.7%. No statistically significant differences were found in the use of computerized tomography, but hospital admissions were reduced. Conclusions: Implementation of the protocol reduced the number of radiographies and increased appropriate use of this resource. Clinical audits of pediatric emergency units should be carried out systematically to produce changes that improve the appropriateness of healthcare.