American Academy Of Pediatrics
Enviado por TACUHOMS • 10 de Junio de 2015 • 2.180 Palabras (9 Páginas) • 246 Visitas
AMERICAN ACADEMY OF PEDIATRICS
The Management of Minor Closed Head Injury in Children
Committee on Quality Improvement, American Academy of Pediatrics
Commission on Clinical Policies and Research, American Academy of Family Physicians
ABSTRACT. The American Academy of Pediatrics
(AAP) and its Committee on Quality Improvement in
collaboration with the American Academy of Family
Physicians (AAFP) and its Commission on Clinical Poli-
cies and Research, and in conjunction with experts in
neurology, emergency medicine and critical care, re-
search methodologists, and practicing physicians have
developed this practice parameter. This parameter pro-
vides recommendations for the management of a previ-
ously neurologically healthy child with a minor closed
head injury who, at the time of injury, may have experi-
enced temporary loss of consciousness, experienced an
impact seizure, vomited, or experienced other signs and
symptoms. These recommendations derive from a thor-
ough review of the literature and expert consensus. The
methods and results of the literature review and data
analyses including evidence tables can be found in the
technical report. This practice parameter is not intended
as a sole source of guidance for the management of
children with minor closed head injuries. Rather, it is
designed to assist physicians by providing an analytic
framework for the evaluation and management of this
condition. It is not intended to replace clinical judgment
or establish a protocol for all patients with a minor head
injury, and rarely will provide the only appropriate ap-
proach to the problem.
The practice parameter, “The Management of Minor
Closed Head Injury in Children,” was reviewed by the
AAFP Commission on Clinical Policies and Research and
individuals appointed by the AAFP and appropriate
committees and sections of the AAP including the Chap-
ter Review Group, a focus group of office-based pedia-
tricians representing each AAP District: Gene R. Adams,
MD; Robert M. Corwin, MD; Diane Fuquay, MD; Bar-
bara M. Harley, MD; Thomas J. Herr, MD, Chair; Ken-
neth E. Matthews, MD; Robert D. Mines, MD; Lawrence
C. Pakula, MD; Howard B. Weinblatt, MD; and Delosa A.
Young, MD.
The supporting data are contained in a technical report
available at http://www.pediatrics.org/cgi/content/full/
104/6/e78.
ABBREVIATIONS. AAP, American Academy of Pediatrics; AAFP,
American Academy of Family Physicians; CT, cranial computed
tomography; MRI, magnetic resonance imaging.
Minor closed head injury is one of the most frequent
reasons for visits to a physician.
1
Although
.
95 000
children experience a traumatic brain injury each
year in the United States,
2
consensus is lacking about
the acute care of children with minor closed head
injury. The evaluation and management of injured
children may be influenced by local practice cus-
toms, settings where children are evaluated, the type
and extent of financial coverage, and the availability
of technology and medical staffing.
Because of the magnitude of the problem and the
potential seriousness of closed head injury among
children, the AAP and the American Academy of
Family Physicians (AAFP) undertook the develop-
ment of an evidence-based parameter for health care
professionals who care for children with minor
closed head injury. In this document, the term Sub-
committee is used to denote the Subcommittee on
Minor Closed Head Injury, which reports to the AAP
Committee on Quality Improvement, and the AAFP
Commission on Clinical Policies, Research, and Sci-
entific Affairs.
While developing this practice parameter, the Sub-
committee attempted to find evidence of benefits
resulting from 1 or more patient management op-
tions. However, at many points, adequate data were
not
...