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What is the best way to monitor a child after head injury?

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Youngblut, J., Caicedo, C., & Brooten, D. (2013). Preschool children with head injury: Comparing injury severity measures and clinical care. Pediatric Nursing, 39(6), 290-298.

The potential for permanent damage and death makes monitoring children with head injuries extremely important. Time is also a crucial factor, especially in the first few days following the injury. Therefore, that time period and the events that occur are thought to be indicators of the child's prognosis.

Youngblut, Caicedo, and Brooten's (2013) study question is aimed at understanding the value of clinical tools commonly used for children who have head injuries. One tool is said to be the "gold standard" for assessing neurological status in these children. Some recent evidence suggested a different tool might be better for this purpose than the older one.

Because neurological status is difficult to ascertain quickly and changes rapidly and frequently, it is important to have a quick assessment tool that is reliable and comprehensive enough to look at multiple body systems. As described in other articles in this issue, the first 24 to 48 hours are critical to the child's long-term outcomes. Recognition of early symptoms can help caregivers prevent further injury. Thus, indications of the patient's status during the period the tools are being used are important information. As a result, the authors chose the information available about specific aspects of the child's status, including his or her condition at discharge or transfer when they collected data. They also included the setting for care because some children were on a general pediatric unit and others in pediatric intensive care units (PICUs).

Their findings suggest that these tools may measure different aspects of injury and may be most effective at different stages in the children's treatment. Having an additional tool to evaluate the child with a head injury should be valuable to caregivers. The additional information from the Abbreviated Injury Scale (AIS) about involvement of other body systems might prevent complications and improve outcomes. Researchers may be able to replicate these findings, and as a result, clinicians may have a new tool to augment their assessment skills for children with head injuries. These findings have the potential to improve the quality of care by using the best available tools, collecting detailed subjective and objective clinical data, and measuring outcomes longitudinally.

With Demystifying Research, nursing research leaders comment on some aspect of a research article featured in the issue, with the aim of helping the reader better understand research. Look for Demystifying Research in each issue of Pediatric Nursing.


Youngblut, J., Caicedo, C., & Brooten, D. (2013). Preschool children with head injury: Comparing injury severity measures and clinical care. Pediatric Nursing, 39(6), 290-298

Jean Ivey, PhD, CRNP, PNP-BC, FAANP, is Associate Professor, University of Alabama at Birmingham, School of Nursing, Birmingham, AL, and a member of the Pediatric Nursing Editorial Board.

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Title Annotation:Demystifying Research
Author:Ivey, Jean
Publication:Pediatric Nursing
Geographic Code:1USA
Date:Nov 1, 2013
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