By Jeff Russ, MD, PhD – Pediatric/Child Neurology Resident, UCSF
Dr. Jeff Russ
Children presenting with head injury are as unremitting in children’s hospitals as the “Frozen” soundtrack, and any physician in a pediatric ED inevitably manages their fair share. The ramifications of missing significant injury to a child’s delicate, developing brain are unnerving. A head CT is central to catching intracranial pathology, but widespread use is not benign, given the risk of malignancy from unnecessary radiation. However, criteria for judiciously navigating this tradeoff remain debated. When is CT appropriate for children with GCS scores of 13-15 and mild symptoms like transient loss of consciousness or vomiting?
Continue reading “Heads Up on Head Injury Algorithms: The Cost of High Sensitivity”
Bacterial meningitis is a rare but serious disease, with mortality approaching 100% when left untreated. On the flip side, many children with mild viral illness are admitted with questionable benefit. The Bacterial Meningitis Score can help support a clinician’s decision to discharge a child safely. We talked with Dr. Lise Nigrovic, first author on the derivation and validation studies.
Dr. Lise Nigrovic
Why did you develop the Bacterial Meningitis Score? Was there a particular clinical experience or patient encounter that inspired you to create this tool for clinicians?
When I was a resident in pediatrics, I found myself admitting well-appearing children who had meningitis, spent two days in the hospital, and then went home after their cultures were negative. Doing that over and over again made me wonder if we could do better and distinguish between children who have
Continue reading “Insights from Dr. Lise Nigrovic, Creator of the Bacterial Meningitis Score for Children”