Emergency department (ED) physicians take potential head injuries seriously, perhaps too much so, according to a study in the American Journal of Roentgenology.
Patients complaining of dizziness, syncope, or near-syncope too often get head CT scans, say researchers at the University of Hawaii and Kaiser Foundation Hospital.
Fewer than 7.1% of 253 patients complaining of dizziness and 6.4% of 236 patients complaining of syncope or near-syncope “may not benefit from head CT.” In fact, say the researchers, the scans result in unnecessary radiation exposure. Too often, the tests are used for screening, rather than diagnosis. The fault, apparently, lies not in the physicians but in guidelines—or lack of them.
The study notes there is considerable uncertainty about how to manage these patients and not miss a life-threatening cause.
Patients often can’t describe dizziness, and those with syncope may not recall if they actually lost consciousness. And there’s some overlap. What’s needed is a clinical algorithm that determines just which patients should get a head CT scan, the study states.