Baby Trauma Drama: Initial Evaluation and Management of Minor Head Trauma in Infants & Children

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0.5 CE Credit

Speaker: Ashton Glover, DNP, FNP-C, ENP-C, SANE-A and Amanda Hitt, MSN, FNP-BC

The purpose of this presentation is to review current, evidence-based guidelines regarding the initial evaluation and management of infants and young children presenting to the emergency department with minor head trauma. Minor head trauma is one of the most common reasons for pediatric emergency department (ED) visits among infants and small children (Mastrangelo & Midulla, 2017). The majority of these injuries are mild in the absence of neurological abnormalities and can therefore be appropriately managed by close observation (Shiomi et al., 2016). The American College of Emergency Physicians (ACEP) (2017) does not recommend routine neuroimaging for mild traumatic brain injury (mTBI) in children; however, when treating infants and young children, clinical assessment is more difficult, and infants may present asymptomatically despite the presence of an intracranial injury (Shutzman, 2022). While most cases are not linked to significant brain injury or long-term complications; a small minority of infants with seemingly minor head trauma may have a clinically important traumatic brain injury (ciTBI), necessitating extended observation or acute intervention (Shutzman, 2022). Furthermore, infants can sustain skull fractures and ciTBIs in the setting of minor trauma (Kemp et al., 2016; Shutzman, 2022). Neuroimaging with computed tomography (CT) is fast, painless, and the gold standard for detecting intracranial abnormalities; however, it exposes patients to radiation and increases healthcare costs (Neil et al., 2022). The application of a clinical decision rule such as the Pediatric Emergency Care Applied Research Network (PERCARN) algorithm in conjunction with clinician judgment and parental consultation can assist clinicians in identifying infants at higher risk for TBI while minimizing overuse of CT (California ACEP, n.d.; Shutzman, 2022).

Discuss common findings associated with minor head trauma in infants and young children
Describe the initial evaluation of infants and young children presenting to the emergency department with minor head trauma
Apply the PECARN algorithm to a case of minor, infant head trauma.

AAENP (ABNP #1571) designates this activity for 0.5 hours.

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