{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,24]],"date-time":"2026-01-24T07:05:16Z","timestamp":1769238316144,"version":"3.49.0"},"reference-count":9,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"7","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pediatr Emer Care"],"published-print":{"date-parts":[[2019,7]]},"abstract":"<jats:sec>\n            <jats:title>Background<\/jats:title>\n            <jats:p>There is an increased emphasis on reducing exposure to ionizing radiation in pediatric patients. Guidelines from the Pediatric Emergency Care Applied Research Network help practitioners identify patients at low risk for clinically important traumatic brain injury after head injury.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Objectives<\/jats:title>\n            <jats:p>We seek to determine whether the institution of a pediatric track staffed by pediatric emergency medicine physicians (PEMs) within a community emergency department (ED) impacts the overall utilization of head computed tomography (CT) on children younger than 15 years with head injury.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>We used a retrospective cohort analysis of patients under the age of 15 years presenting to a community ED in the year before and the year of institution of a pediatric emergency track. Relative risk estimates were used to determine the risk of CT use associated with nonpediatric-trained emergency providers.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>The community ED saw 11,094 patients and 14,639 patients younger than 15 years in fiscal years 2014\u20132015 and 2015\u20132016, respectively. In the year before PEMs, there were 312 children younger than 15 years seen for head injury; 47.09% received head CTs. After PEM coverage, there were 396 children younger than 15 years seen for head injury; 17.17% received head CTs. Pediatric patients with head injury were 2.2 times more likely to receive CTs before the institution of the pediatric track (95% confidence interval, 1.8\u20132.6).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>The implementation of a pediatric emergency track demonstrated a significant decrease in CT utilization for head injury. Continued development of pediatric tracks in community EDs can lead to reduction of CTs.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/pec.0000000000001870","type":"journal-article","created":{"date-parts":[[2019,6,17]],"date-time":"2019-06-17T12:53:34Z","timestamp":1560776014000},"page":"506-508","source":"Crossref","is-referenced-by-count":6,"title":["A Specialized Pediatric Emergency Medicine Track Decreases Computed Tomography in Head Injured Patients"],"prefix":"10.1097","volume":"35","author":[{"given":"Heather B.","family":"Conrad","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kathryn A.","family":"Hollenbach","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kristin","family":"Ratnayake","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel L.","family":"Gehlbach","sequence":"additional","affiliation":[{"name":"San Diego State University, San Diego, CA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Keri L.","family":"Carstairs","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","published-online":{"date-parts":[[2019,6,17]]},"reference":[{"key":"bib1-20230930","first-page":"1","article-title":"Traumatic brain injury-related emergency department visits, hospitalizations, and deaths\u2014United States, 2007 and 2013","volume":"66","year":"2017","journal-title":"MMWR Surveill Summ"},{"key":"bib2-20230930","doi-asserted-by":"crossref","first-page":"527","DOI":"10.1001\/jamapediatrics.2015.138","article-title":"A national assessment of pediatric readiness of emergency departments","volume":"169","year":"2015","journal-title":"JAMA Pediatr"},{"key":"bib5-20230930","doi-asserted-by":"crossref","first-page":"700","DOI":"10.1001\/jamapediatrics.2013.311","article-title":"The use of computed tomography in pediatrics and the associated radiation exposure and estimated cancer risk","volume":"167","year":"2013","journal-title":"JAMA Pediatr"},{"key":"bib6-20230930","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":"bib7-20230930","doi-asserted-by":"crossref","first-page":"e20161349","DOI":"10.1542\/peds.2016-1349","article-title":"Reducing head CT use for children with head injuries in a community emergency department","volume":"139","year":"2017","journal-title":"Pediatrics"},{"key":"bib8-20230930","first-page":"2400","article-title":"Use of diagnostic imaging studies and associated radiation exposure for patients enrolled in large integrated health care systems, 1996-2010","volume":"307","year":"2012","journal-title":"JAMA"},{"key":"bib9-20230930","doi-asserted-by":"crossref","first-page":"1491","DOI":"10.1377\/hlthaff.27.6.1491","article-title":"Rising use of diagnostic medical imaging in a large integrated health system","volume":"27","year":"2008","journal-title":"Health Aff (Millwood)"},{"key":"bib10-20230930","doi-asserted-by":"crossref","first-page":"320","DOI":"10.1016\/j.annemergmed.2006.09.025","article-title":"Pediatric head trauma: changes in use of computed tomography in emergency departments in the United States over time","volume":"49","year":"2007","journal-title":"Ann Emerg Med"},{"key":"bib11-20230930","doi-asserted-by":"crossref","first-page":"694","DOI":"10.1111\/j.1553-2712.2010.00797.x","article-title":"Neuroimaging for pediatric head trauma; do patient and hospital characteristics influence who gets imaged?","volume":"17","year":"2010","journal-title":"Acad Emerg Med"}],"container-title":["Pediatric Emergency Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/00006565-201907000-00009","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,30]],"date-time":"2023-09-30T08:18:35Z","timestamp":1696061915000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/00006565-201907000-00009"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,6,17]]},"references-count":9,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2019]]}},"URL":"https:\/\/doi.org\/10.1097\/pec.0000000000001870","relation":{},"ISSN":["1535-1815","0749-5161"],"issn-type":[{"value":"1535-1815","type":"electronic"},{"value":"0749-5161","type":"print"}],"subject":[],"published":{"date-parts":[[2019,6,17]]}}}