{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T23:44:31Z","timestamp":1787010271086,"version":"build-2736575974"},"reference-count":9,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"8","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pediatr Emer Care"],"published-print":{"date-parts":[[2020,8]]},"abstract":"\n Objectives<\/jats:title>\n We describe ondansetron use in children with head injury evaluated in pediatric emergency departments and its association with return visits and late diagnoses of intracranial injuries requiring intervention.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n Children ages 6 months to 18 years discharged without neuroimaging from 35 pediatric emergency departments with a diagnosis of head injury from 2009 to 2013 were identified retrospectively from the Pediatric Health Information System. We evaluated the rates of ondansetron use during the study period and of the association of ondansetron treatment with the diagnosis of intracranial injury, skull fracture, and return visits within 72 hours requiring admission or operative intervention.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n We identified 218,904 encounters during the study period. Of these, 5894 patients (2.8%) were given ondansetron. There was significant variation in the use of ondansetron during the index visit between hospitals (0.1%\u20135.7%), and ondansetron use significantly increased over the study period. Return visits within 72 hours were more likely for patients treated with ondansetron during the index visit (3.7% vs 1.9%; adjusted odds ratio, 1.99; 95% confidence interval, 1.7\u20132.4). These patients were more likely to be admitted than those not treated initially with ondansetron (7% vs 4%; adjusted odds ratio, 1.97; 95% confidence interval, 1.09\u20133.55). There were no significant differences in rates of skull fractures, intracranial injury, intensive care unit admission, or operative intervention between groups.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Ondansetron use during an initial emergency department visit for head trauma in children not requiring neuroimaging is associated with a higher likelihood of return within 72 hours and subsequent admission. There were no differences in rates of missed skull fractures, intracranial injury, intensive care admission, or operative intervention for groups who were and were not treated with ondansetron; however, this study was underpowered to detect significant differences in these categories. Future investigations with greater numbers would be required to confidently assess these critical differences.<\/jats:p>\n <\/jats:sec>","DOI":"10.1097\/pec.0000000000001315","type":"journal-article","created":{"date-parts":[[2017,10,17]],"date-time":"2017-10-17T13:13:42Z","timestamp":1508246022000},"page":"e433-e437","source":"Crossref","is-referenced-by-count":4,"title":["Use of Ondansetron for Vomiting After Head Trauma"],"prefix":"10.1097","volume":"36","author":[{"given":"Israel","family":"Green-Hopkins","sequence":"first","affiliation":[{"name":"Division of Pediatric Emergency Medicine, UCSF Benioff Children's Hospital, San Francisco, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael C.","family":"Monuteaux","sequence":"additional","affiliation":[{"name":"Division of Emergency Medicine, Boston Children's Hospital, Department of Emergency Medicine, Harvard Medical School, Boston, MA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lois K.","family":"Lee","sequence":"additional","affiliation":[{"name":"Division of Emergency Medicine, Boston Children's Hospital, Department of Emergency Medicine, Harvard Medical School, Boston, MA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lise E.","family":"Nigrovic","sequence":"additional","affiliation":[{"name":"Division of Emergency Medicine, Boston Children's Hospital, Department of Emergency Medicine, Harvard Medical School, Boston, MA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebekah","family":"Mannix","sequence":"additional","affiliation":[{"name":"Division of Emergency Medicine, Boston Children's Hospital, Department of Emergency Medicine, Harvard Medical School, Boston, MA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara A.","family":"Schutzman","sequence":"additional","affiliation":[{"name":"Division of Emergency Medicine, Boston Children's Hospital, Department of Emergency Medicine, Harvard Medical School, Boston, MA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2017,10,16]]},"reference":[{"key":"bib1-20230930","doi-asserted-by":"crossref","first-page":"1160","DOI":"10.1016\/S0140-6736(09)61558-0","article-title":"Identification of children at very low risk of clinically-important brain injuries after head trauma: a prospective cohort study","volume":"374","year":"2009","journal-title":"Lancet"},{"key":"bib2-20230930","doi-asserted-by":"crossref","first-page":"657","DOI":"10.1016\/j.annemergmed.2014.01.009","article-title":"Association of traumatic brain injuries with vomiting in children with blunt head trauma","volume":"63","year":"2014","journal-title":"Ann Emerg Med"},{"key":"bib3-20230930","article-title":"Antiemetic treatment for acute gastroenteritis in children: an updated Cochrane systematic review with meta-analysis and mixed treatment comparison in a Bayesian framework","volume":"2","year":"2012","journal-title":"BMJ Open"},{"key":"bib4-20230930","doi-asserted-by":"crossref","first-page":"166","DOI":"10.1016\/j.ajem.2012.07.002","article-title":"The use of ondansetron for nausea and vomiting after head injury and its effect on return rates from the pediatric ED","volume":"31","year":"2013","journal-title":"Am J Emerg Med"},{"key":"bib5-20230930","doi-asserted-by":"crossref","first-page":"887","DOI":"10.1542\/peds.109.5.887","article-title":"Characteristics of deaths occurring in children's hospitals: implications for supportive care services","volume":"109","year":"2002","journal-title":"Pediatrics"},{"key":"bib7-20230930","doi-asserted-by":"crossref","first-page":"983","DOI":"10.1542\/peds.107.5.983","article-title":"Evaluation and management of children younger than two years old with apparently minor head trauma: proposed guidelines","volume":"107","year":"2001","journal-title":"Pediatrics"},{"key":"bib8-20230930","doi-asserted-by":"crossref","first-page":"458","DOI":"10.1097\/PEC.0000000000000161","article-title":"Management of pediatric patients with concussion by emergency medicine physicians","volume":"30","year":"2014","journal-title":"Pediatr Emerg Care"},{"key":"bib9-20230930","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1053\/ajem.2001.18041","article-title":"Insurance status and admission to hospital for head injuries: are we part of a two-tiered medical system?","volume":"19","year":"2001","journal-title":"Am J Emerg Med"},{"key":"bib10-20230930","doi-asserted-by":"crossref","first-page":"732","DOI":"10.1001\/archpediatrics.2012.307","article-title":"Cranial computed tomography use among children with minor blunt head trauma: association with race\/ethnicity","volume":"166","year":"2012","journal-title":"Arch Pediatr Adolesc Med"}],"container-title":["Pediatric Emergency Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/10.1097\/PEC.0000000000001315","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,30]],"date-time":"2023-09-30T04:29:18Z","timestamp":1696048158000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.1097\/PEC.0000000000001315"}},"subtitle":["Does It Mask Clinically Significant Traumatic Brain Injury?"],"short-title":[],"issued":{"date-parts":[[2017,10,16]]},"references-count":9,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2020]]}},"URL":"https:\/\/doi.org\/10.1097\/pec.0000000000001315","relation":{},"ISSN":["1535-1815","0749-5161"],"issn-type":[{"value":"1535-1815","type":"electronic"},{"value":"0749-5161","type":"print"}],"subject":[],"published":{"date-parts":[[2017,10,16]]}}}