Emergency Treatment of Head Injuries in Children at the Clinical Hospital Centre Osijek

Ciljevi rada su istražiti broj učinjenih hitnih radioloških pretraga, ordinirane pretrage i udio pozitivnih nalaza (fraktura neurokranija) kod djece, napraviti raspodjelu mehanizma ozljeda, te istražiti postoji li razlika u ordiniranim pretragama među pacijentima koji su primljeni na bolničko liječenje odnosno otpušteni iz bolnice. Uzorak čine djeca do 14 godina koja su zbog ozlijeda glave s hitnog prijema upućena na radiološku obradu. Retrospektivno istraživanje provedeno je uvidom u informacijski sustav Kliničkog bolničkog centra Osijek, a razdoblje istraživanja je od 01.01.2019. – 30.06.2019. godine. U istraživanju je sudjelovalo 295 pacijenata, od kojih je kod 293 učinjen kraniogram, a kod 2 pacijenta samo CT mozga i kostiju glave. Kod 111 pacijenata uz kraniogram je ordinirana i dodatna snimka. Dva pacijenta su nakon učinjenog kraniograma upućeni na CT radi dodatne evaluacije. Nakon učinjenog kraniograma (i specijalnih snimki) kod 280 pacijenata isključila se mogućnost postojanja frakture neurokranija, a kod 13 pacijenata vidljive su transparencije koje mogu odgovarati frakturi. Na CT dijagnostici kod 2 pacijenta je bila vidljiva fraktura eurokranija dok je kod 2 pacijenta ista isključena. Hospitalizirano je 42 djece dok su kod 12 pacijenata roditelji/skrbnici odbili hospitalizaciju. Prosječno trajanje hospitalizacije bilo je 2,6 dana. Kraniocerebralne ozlijede su česte u pedijatrijskoj populaciji, međutim u većini slučajeva bez ozbiljnijih posljedica. Prema najnovijim smjernicama, ne preporuča se ordiniranje kraniograma kod traumatskih ozlijeda glave.The aim of the study is to investigate the number of performed radiological examinations, examinations and the part of positive findings (skull fractures) in children, to distribute the mechanism of injuries, and to investigate whether there is a difference in prescribed examinations among patients admitted to hospital or discharged from the hospital. Children up to 14 years of age who were referred for X – ray and/or head CT from the emergency department due to head injuries were part of this study. The retrospective research was conducted by inspecting the information system of the Clinical Hospital Centre Osijek. Research period was from January 1st 2019. to June 30th 2019. The study involved 295 patients, of whom 293 had a skull X – ray, and two patients had only CT – head scan. In 111 patients, an additional X – ray projection was administered in addition to the standard skull X – ray projections. Two patients required computed tomography after an X – ray was performed. After the skull X – ray (and additional projections) were performed, skull fracture was ruled out in 280 patients, and transparencies that may correspond to the fracture were visible in 13 patients. Two patients that underwent CT – head scans had a skull fracture, while in two patients it was ruled out. 42 children were hospitalized, while hospitalization was refused in 12 patients by parents or legal guardians. The mean hospital stay was 2.6 days. Craniocerebral injuries are common in the paediatric population, however in most cases without more serious consequences. According to the latest guidelines, plain skull X – rays should not be used in traumatic head injuries management