PECARN rule in diagnostic process of pediatric patients with minor head trauma in emergency department

Abstract Aim: To evaluate the efficacy of the PECARN Rule (PR) in preventing the presence of clinically important traumatic brain (ciTBI).Methods: A retrospective study was performed to our hospital between July 2015 and June 2020. Data of all children <18 years of age admitted to the Emergency Department (ED), within the 24 hours after a head trauma with GCS ≥14, were analysed. PR was retrospectively applied to all patientsResults: 3832 patients were enrolled, 2613 patients ≥2 years and 1219 were younger. In the group of children ≥2 years, 10 presented ciTBI of which 7 underwent neurosurgery and 3 hospitalized. Applying the PR, no patient with ciTBI would have been discharged without a diagnosis. Between children <2 years, only 3 patients presented ciTBI, 2 underwent neurosurgery and 1 hospitalized. According the PR also in this age group no ciTBI would have been discharged without diagnosis. Conclusions: We demonstrate the total effectiveness of the PR in our setting. We found 100% sensitivity in both age groups in identifying patients with ciTBI. Therefore, in patients classified in the low-risk category, it is a duty of the physician not to expose the child to ionizing radiation.