{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T00:05:11Z","timestamp":1767830711158,"version":"3.49.0"},"reference-count":70,"publisher":"BMJ","issue":"2","license":[{"start":{"date-parts":[[2024,2,14]],"date-time":"2024-02-14T00:00:00Z","timestamp":1707868800000},"content-version":"unspecified","delay-in-days":13,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"HEE\/NIHR integrated clinical and practitioner programme's doctoral clinical and practitioner academic fellowship (DCAF) scheme","award":["25215"],"award-info":[{"award-number":["25215"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2024,1,31]]},"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Hospital-based clinical decision tools support clinician decision-making when a child presents to the emergency department with a head injury, particularly regarding CT scanning. However, there is no decision tool to support prehospital clinicians in deciding which head-injured children can safely remain at scene. This study aims to identify clinical decision tools, or constituent elements, which may be adapted for use in prehospital care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Systematic mapping review and narrative synthesis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data sources<\/jats:title>\n                    <jats:p>Searches were conducted using MEDLINE, EMBASE, PsycINFO, CINAHL and AMED.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Eligibility criteria<\/jats:title>\n                    <jats:p>Quantitative, qualitative, mixed-methods or systematic review research that included a clinical decision support tool for assessing and managing children with head injury.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data extraction and synthesis<\/jats:title>\n                    <jats:p>We systematically identified all in-hospital clinical decision support tools and extracted from these the clinical criteria used in decision-making. We complemented this with a narrative synthesis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Following de-duplication, 887 articles were identified. After screening titles and abstracts, 710 articles were excluded, leaving 177 full-text articles. Of these, 95 were excluded, yielding 82 studies. A further 14 studies were identified in the literature after cross-checking, totalling 96 analysed studies. 25 relevant in-hospital clinical decision tools were identified, encompassing 67 different clinical criteria, which were grouped into 18 categories.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Factors that should be considered for use in a clinical decision tool designed to support paramedics in the assessment and management of children with head injury are: signs of skull fracture; a large, boggy or non-frontal scalp haematoma neurological deficit; Glasgow Coma Score less than 15; prolonged or worsening headache; prolonged loss of consciousness; post-traumatic seizure; amnesia in older children; non-accidental injury; drug or alcohol use; and less than 1 year old. Clinical criteria that require further investigation include mechanism of injury, clotting impairment\/anticoagulation, vertigo, length of time of unconsciousness and number of vomits.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2023-078363","type":"journal-article","created":{"date-parts":[[2024,2,13]],"date-time":"2024-02-13T23:41:59Z","timestamp":1707867719000},"page":"e078363","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Which elements of hospital-based clinical decision support tools for the assessment and management of children with head injury can be adapted for use by paramedics in prehospital care? A systematic mapping review and narrative synthesis"],"prefix":"10.1136","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5763-5419","authenticated-orcid":false,"given":"Alyesha","family":"Proctor","sequence":"first","affiliation":[{"name":"University of the West of England, Bristol, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark","family":"Lyttle","sequence":"additional","affiliation":[{"name":"Faculty of Health and Applied Sciences, University of the West of England Bristol, Bristol, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jedd","family":"Billing","sequence":"additional","affiliation":[{"name":"University of the West of England, Bristol, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pauline","family":"Shaw","sequence":"additional","affiliation":[{"name":"University of the West of England, Bristol, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julian","family":"Simpson","sequence":"additional","affiliation":[{"name":"University of the West of England, Bristol, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5044-5145","authenticated-orcid":false,"given":"Sarah","family":"Voss","sequence":"additional","affiliation":[{"name":"Health and Life Sciences, University of the West of England, Bristol, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonathan Richard","family":"Benger","sequence":"additional","affiliation":[{"name":"Academic Department of Emergency Care, The University Hospitals NHS Foundation Trust, Bristol, UK"},{"name":"Faculty of Health & Life Sciences, University of the West of England, Bristol, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2024,2,13]]},"reference":[{"key":"2025121219434731000_14.2.e078363.1","unstructured":"NHS . 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