{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,6,24]],"date-time":"2025-06-24T06:02:24Z","timestamp":1750744944168,"version":"3.37.3"},"reference-count":35,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2014,6,16]],"date-time":"2014-06-16T00:00:00Z","timestamp":1402876800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100001511","name":"Auckland Medical Research Foundation","doi-asserted-by":"crossref","award":["1309001"],"award-info":[{"award-number":["1309001"]}],"id":[{"id":"10.13039\/501100001511","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Emerg Medicine Australasia"],"published-print":{"date-parts":[[2014,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Accurate diagnosis, treatment and follow up of children suffering mild traumatic brain injury (<jats:styled-content style=\"fixed-case\">MTBI<\/jats:styled-content>) is important as post\u2010concussive symptoms and long\u2010term disability might occur. This research explored the decisions clinicians make in their assessment and management of children with <jats:styled-content style=\"fixed-case\">MTBI<\/jats:styled-content> in acute care settings, and identified barriers and enablers to the delivery of best\u2010practice care.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A purposeful sample of 29 clinicians employed in two metropolitan paediatric <jats:styled-content style=\"fixed-case\">EDs<\/jats:styled-content> and one Urgent Care clinic was surveyed using a vignette\u2010based questionnaire that also included domains of guideline awareness, attitudes to <jats:styled-content style=\"fixed-case\">MTBI<\/jats:styled-content> care, use of clinical decision support systems, and knowledge and skills for practising evidence\u2010based healthcare.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Overall, the evaluation and management of children presenting acutely with <jats:styled-content style=\"fixed-case\">MTBI<\/jats:styled-content> generally followed best\u2010practice guidelines, particularly in relation to identifying intracranial injuries that might require surgical intervention, observation for potential deterioration, adequate pain management and the provision of written head injury advice on discharge. Larger variation emerged in regard to follow\u2010up care and referral pathways. Potential barriers to best\u2010 practice were lack of guideline awareness, attitudes to <jats:styled-content style=\"fixed-case\">MTBI<\/jats:styled-content>, and lack of time or other priorities.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Opportunities exist to improve care for children who present in acute care settings following mild traumatic brain injury. These include having up\u2010to\u2010date guidelines that are consistent across acute care settings; providing clearer pathways for referral and follow up; targeting continuing medical education towards potential complications; and providing computerised decision support so that assessment and management are conducted systematically.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1742-6723.12255","type":"journal-article","created":{"date-parts":[[2014,6,16]],"date-time":"2014-06-16T23:17:06Z","timestamp":1402960626000},"page":"376-383","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Mild traumatic brain injury in children: Management practices in the acute care setting"],"prefix":"10.1111","volume":"26","author":[{"given":"Bridget","family":"Kool","sequence":"first","affiliation":[{"name":"Epidemiology and Biostatistics University of Auckland  Auckland New 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