Shared Decision Making in Parents of Children With Head Trauma: Head CT Choice
"Decision aid, Head CT Choice, to determine if improves parents' knowledge and engagement in decision making regarding child's head trauma"
Age:
0 to 18 years old
Gender:
Any
Healthy Volunteers:
No
Keywords:
head injury, children, blunt head trauma, head CT
Type:
Other study
Investigator:
Description
The purpose of this research study is to look at the way emergency department doctors and parents of children with a head injury discuss and decide what tests to perform in the process of diagnosis for head injury.
The researchers will test the impact of a decision aid, Head CT Choice, to determine if its use improves parents' knowledge and engagement in decision making and safely decreases healthcare utilization in children presenting to the emergency department with blunt head trauma.
This study requires
Short survey before and after speaking with child's clinician

Your child’s clinician will either provide usual standard patient care, or in addition to providing standard patient care the clinician will utilize a Head CT Choice Decision Aid to educate the parents of children on their child’s condition and what options are available for the parents to choose from in caring for the child. Depending upon which group the clinician is in, he/she will share information with you in a certain way.

Complete diary of any details of healthcare service use after leaving emergency department

Follow up calls/emails
Who can participate?
Inclusion Criteria:

Parents and their child, seeking care for a child who:

1. Is < 18 years of age;

2. Had blunt trauma above the eyebrows (not isolated to face or eyes);

3. Is positive for at least 1 of the PECARN clinical prediction rule predictors described below:

PECARN Predictors for children < 2 years of age:

Severe mechanism (PECARN definition)* Loss of consciousness > 5 seconds Acting abnormally per parent Initial ED GCS < 15 by attending (or CT decision-maker) Other signs of altered mental status (PECARN definition) Presence of occipital, temporal or parietal scalp hematoma Palpable skull fracture or unclear if skull fracture

PECARN predictors for children 2-18 years of age:

Severe mechanism (PECARN definition)* Any loss of consciousness Any vomiting since the injury Severe headache in ED Initial ED GCS < 15 by attending (or CT decision-maker) Other signs of altered mental status (PECARN definition)** Any sign of basilar skull fracture Clinicians include attending physicians and fellows or midlevel providers caring for children with head trauma


Exclusion Criteria:

Parents of children with:

1. GCS scores < 15

2. Evidence of penetrating trauma, signs of basilar skull fracture, or depressed skull fracture on physical examination

3. Brain tumors

4. Ventricular shunts

5. Bleeding disorder

6. Pre-existing neurological disorders complicating assessment

7. Neuroimaging at an outside hospital before transfer

8. Signs of altered mental status (agitation, somnolence, repetitive questioning, or slow response to verbal communication)

9. Syncope or seizure disorder preceded (led to) head trauma or seizure post head trauma

10. Known to be pregnant

11. Communication barriers such as visual or hearing impairment that may preclude use of the decision aid.

12. Strong suspicion of abuse for this head injury
Resources
Schedule
Study duration and period
7 days
Recruitment period
From April 30, 2014
Location
UC Davis Children's Hospital
2315 Stockton Boulevard
Sacramento, CA 95817
Contact
Rebecca Kim
Research Topic
Conditions:
  • Head Injury

Have any questions or want to learn more? Leave your contact details below and the research team will reach out to you.


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