A planned secondary analysis of a prospective, multicentre cohort study.
Nine emergency departments (ED) within the Pediatric Emergency Research Canada Network.
Aged between 5.00 and 17.99 years and diagnosed with a concussion following a traumatic head injury in the preceding 48 hours.
Return to physical activity within 7 days postinjury (ranging from light exercise to a full return to competitive sports).
No physical activity within 7 days postinjury. Propensity scores were derived to account for potential confounding baseline characteristics. Patients in each intervention group were matched 1:1 in random order based on the propensity scores.
Age, sex, duration of prior concussion, duration of loss of consciousness, presence of symptoms on the initial concussion evaluation, personal/family history of migraine, learning/developmental disorder, attention deficit hyperactivity disorder, sleep disorder, other psychiatric disorders.
Prospective, single-centre, non-blinded randomised controlled trial. Randomised using block randomisation sequence with random sized blocks
Patients: Infants aged 0 to 6 months attending when a sonographer was available. Those with spinal cord abnormalities or who are non-English speaking were excluded.
Intervention: Ultrasound (US)-guided marking of the intervertebral space and midline, compared with no marking. The US technique was taught to three individuals. The clinician performing the procedure was decided prior to randomisation.
Primary outcome: First lumbar puncture attempt successful with cerebrospinal fluid (CSF) and <1000 mm3 red blood cells.
Secondary: Success within three attempts.
Follow-up period: Nil after result obtained
One hundred and twenty-eight patients were enrolled, median age 26 days. US marking improved the success rate for the first and subsequent lumbar puncture attempts. There was no difference in the clinicians’ experience between the groups but the improvement in success rate with US was most marked in...]]>