Written by Jason Lesnick
Newer CT scanners led to faster head CT by about 10 seconds, and this decreased the number of pediatric patients who required sedation.
Why does this matter?
Sedating pediatric patients to obtain images is sometimes necessary. If we can decrease the number of pediatric patients requiring sedation while still obtaining the indicated imaging for evaluation, this should decrease overall resource utilization and length of stay. Would a faster scanner help?
“The faster the donut of truth, the less sedation there is.” – Yoda, probably
Two pediatric EDs within one hospital system performed a retrospective chart review of 15,175 patient encounters over a four year study period after new CT scanners were installed. Image time decreased from 12 to 2 seconds. They found a statistically significant decrease in the percentage of patients who required sedation to complete head CT from 8.4% to 7.5%. Unsurprisingly, patients who required sedation had a longer length of stay by an average of 37 minutes. The most commonly administered sedative was midazolam, both before (51%) and after (62%) the CT scanners were upgraded. The only other significant difference noted with medications selected was a significant decrease in use of propofol either alone (30 patients to 0 patients) or in combination (26 to 3) from the before to after period.
The decrease in the number of patients who required sedation was small, but if I can avoid sedating a child, that’s a win in my book. The best predictor of sedation for imaging was age; median age of those who received sedation was two years old compared to seven years old for those who did not require sedation.
If you have a choice between a new CT scanner and an one old in your ED, ensure your pediatric patient goes to the new one!
Impact of a Faster Computed Tomography Scanner on Sedation for Pediatric Head Computed Tomography Scans in 2 Large Emergency Departments-A Retrospective Study. Pediatr Emerg Care. 2022 Aug 5. doi: 10.1097/PEC.0000000000002816. Online ahead of print.