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Imaging paediatic facial injuries in the emergency department
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Long, L., Trivedy, Chetan R., Crossman, Richard, Flowers, M. J. and Cooke, Matthew (2014) Imaging paediatic facial injuries in the emergency department. Emergency Medicine Journal, 31 (9). pp. 782-783. doi:10.1136/emermed-2014-204221.13
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Official URL: http://dx.doi.org/10.1136/emermed-2014-204221.13
Abstract
Objectives & Background Facial injuries are a common presentation
to the ED with data suggesting that this may be as high as
4%. There is little data on the epidemiology of paediatric facial
injuries and how these are managed by the ED team. The exposure
of structures such as the eyes, brain and thyroid to ionising
radiation may be potentially harmful and at present there are no
nationally agreed guidelines on which patients require imaging
in the ED. The aim of this study was to look at the patterns of
imaging in a cohort of paediatric facial injuries presenting to an
ED in the West Midlands.
Methods A retrospective note review of all facial injuries presenting
to any one of the three sites that make up the Heart of
England NHS Foundation Trust in 2012 was conducted.
Electronic records were examined to look for the mechanism of
injury, disposal as well if any imaging had been performed
during the initial presentation. Where imaging was performed
the actual imaging as well as formal radiology reports were
accessed to ascertain for the presence or absence of a facial fracture.
Results Paediatric facial injuries made up 1131/3416 (33%) of
the overall number of facial emergencies presenting to the ED
in 2012. The mean age for the children was 6.9±4.3 years.
32% of the children were female as opposed to 68% who were
male. 164/1131(14.5%) children were imaged and of these only
17/164 (10.4%) were confirmed to have a fracture. In contrast
47% of the adults were imaged and 26% of these were con-
firmed to have a facial fracture. Chi-squared tests demonstrated
that the proportion of patients who had imaging requested was
significantly lower in the paediatric cohort when compared to
adults (P<0.005). Also the difference in the numbers of con-
firmed facial fractures in those who were imaged was signifi-
cantly lower in children when compared to the adults
(P<0.005). Occipitomental (OM) and orthopantomograms
(OPG) were the commonest facial views requested for both the
paediatric and adult facial injuries.
Conclusion The study highlights that paediatric facial injuries
are less common than adult facial injuries and that facial fractures
make up only 1.5% of all paediatric facial injuries. Clinicians
should consider this when requesting facial X-rays given the
potential harm of ionising radiation to the head and neck region.
Further studies are in progress to develop evidence based guidelines
for imaging children with facial injuries within the ED.
| Item Type: | Journal Article | ||||
|---|---|---|---|---|---|
| Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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| Journal or Publication Title: | Emergency Medicine Journal | ||||
| Publisher: | BMJ Group | ||||
| ISSN: | 1472-0205 | ||||
| Official Date: | September 2014 | ||||
| Dates: |
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| Volume: | 31 | ||||
| Number: | 9 | ||||
| Page Range: | pp. 782-783 | ||||
| DOI: | 10.1136/emermed-2014-204221.13 | ||||
| Status: | Peer Reviewed | ||||
| Publication Status: | Published | ||||
| Access rights to Published version: | Restricted or Subscription Access |
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