Management of head injury in children less than 2 years of age : high time for a guideline

The assessment of children aged less than two years who present with head injury poses a challenge to the examining doctor due to the inability of the patient to give a history. A literature search found only two sets of guidelines which include the management of children less than 2 years of age, namely the National Institute for Clinical Excellence (NICE) and the Division of Emergency Medicine, Children's Hospital of Harvard (DEMCHH) guidelines. A retrospective study was carried to assess current practice in the A&E department of St. Luke's Hospital. Our study showed that most patients (94%) underwent radiological investigation and more than 55% were advised admission. The development and implementation of evidence based guidelines would decrease the number of radiological investigations performed and the number of patient admissions.peer-reviewe