Emergency Physicians Awareness of Computed Tomography Indication in Traumatic Brain Injury: A Questionnaire-Based Study

Minor head injury (MHT) is one of the most common causes of all trauma admissions and it is still controversial to manage adequately. Although the incidence of clinically significant traumatic brain injury is low in this group, the consequences of missing clinically important problem are potentially life threatening. Early diagnosis of intracranial hematoma by computed tomography scan (CT) followed by early surgery is very important in the treatment of such patients. Thus, there has been a tendency to use high levels of diagnostic imaging in these conditions. There are many decision rules for the use of computed tomography (CT) for patients with minor head injury. This survey is to determine the awareness and utilization rates of these head CT rules among our emergency physicians (EP). Questionnaire was randomly sent to EPs from different ministry of health hospitals in Makkah. Our participants were asked about their awareness of such rules and their applications in their careers. Data were collected and analyzed by SPSS V16.0. The awareness and utilization rate of clinical decision rules among 91 ER physicians who responded were 54.4% and 42.2% respectively. The barriers to utilize such rules were the working environment and increased chances of getting lawsuits, which were 55.4% and 61.7% respectively. 91.1% of those physicians would like to receive guidance on how to apply such rules in their daily practices. There is a misunderstanding of the definition of minor head injury, despite the high number of head traumas, which led to request more CT scan. This will be a burden on the healthcare system and will lead to more radiation exposure. More educations regarding head CT rules will result in better utilizing of our resources and reduction in radiation risks.