Subject(s)
Managed Care Programs/organization & administration , Needs Assessment , Primary Health Care/organization & administration , Process Assessment, Health Care , Arizona , Community Health Planning , Marketing of Health Services/methods , Models, Organizational , Patient Satisfaction , Patient-Centered Care , Primary Health Care/statistics & numerical dataABSTRACT
A prospective study was undertaken to investigate the significance of Babinski signs in children with head trauma. Thirty-eight children between the ages of 1 and 15 were studied. Twenty-four of the children were admitted to the hospital for observation; 14 were sent home, with 24-hour follow-up in the pediatrics clinic. Of the 24 children admitted, six were believed to have altered CNS status or other focal findings on examination in the emergency department, and 18 were judged by two independent observers to have Babinski signs, either unilateral or bilateral, as their only neurological finding. Twelve hours after admission, all 18 children who had been admitted on the basis of Babinski signs alone had downgoing toes and they continued to have Babinski signs. The isolated presence of Babinski signs in a child with a history of head injury is not indicative of poor neurological outcome. An otherwise asymptomatic child who presents with a history of head injury and a solitary finding of Babinski sign(s) may be observed safely at home rather than being admitted to the hospital for observation.
