The use of handheld near-infrared device (Infrascanner) for detecting intracranial haemorrhages in children with minor head injury |
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Authors: | Silvia Bressan Marco Daverio Francesco Martinolli Daniele Dona’ Federica Mario Ivan P Steiner Liviana Da Dalt |
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Institution: | 1. Department of Woman’s and Child’s Health, University of Padova, Padova, Italy 4. Department of Woman’s and Child’s Health, Division of Pediatric Emergency Medicine, University of Padova, Via Giustiniani 3, 35128, Padova, Italy 2. Pediatric Unit, Ospedale Ca’ Foncello, Treviso, Italy 3. Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada
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Abstract: | Objective A handheld device using near-infrared technology (Infrascanner) has shown good accuracy for detection of traumatic intracranial haemorrhages in adults. This study aims to determine the feasibility of use of Infrascanner in children with minor head injury (MHI) in the Emergency Department (ED). Secondary aim was to assess its potential usefulness to reduce CT scan rate. Methods Prospective pilot study conducted in two paediatric EDs, including children at high or intermediate risk for clinically important traumatic brain injury (ciTBI) according to the adapted PECARN rule in use. Completion of Infrascanner measurements and time to completion were recorded. Decision on CT scan and CT scan reporting were performed independently and blinded to Infrascanner results. Results Completion of the Infrascanner measurement was successfully achieved in 103 (94 %) of 110 patients enrolled, after a mean of 4.4?±?2.9 min. A CT scan was performed in 18 (17.5 %) children. Only one had an intracranial haemorrhage that was correctly identified by the Infrascanner. The exploratory analysis showed a specificity of 93 % (95 % CI, 86.5–96.6) and a negative predictive value of 100 % (95 % CI, 81.6–100) for ciTBI. The use of Infrascanner would have led to avoid ten CT scan, reducing the CT scan rate by 58.8 %. Conclusions Infrascanner seems an easy-to-use tool for children presenting to the ED following a MHI, given the high completion rate and short time to completion. Our preliminary results suggest that Infrascanner is worthy of further investigation as a potential tool to decrease the CT scan rate in children with MHI. |
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