Template:PECARN Head CT Rule

<2 years old

Any 1 of the following?

1. GCS ≤14
2. Altered Mental Status
3. Palpable Skull Fracture

Then obtain a Non-Con Brain CT (4.4% risk of cTBI)

1 or more of the following?

1. Non-frontal scalp hematoma
2. LOC ≥ 5 seconds
3. Severe injury mechanism
   1. pedestrian or bicyclist w/o helmet struck by motorized vehicle
   2. fall >1m or 3ft
   3. head struck by high-impact object
4. Abnormal activity per parents

Then consider a Non-Con Brain CT or Observation (0.9% risk of cTBI)

≥2 years old - 18 years

Any 1 of the following?

1. GCS ≤14
2. Altered Mental Status
3. Signs of a basilar skull fracture

Then obtain a Non-Con Brain CT (4.3% risk of cTBI)

1 or more of the following?

1. History of vomiting^
2. LOC
3. Severe injury mechanism
   1. Pedestrian or bicyclist w/o helmet struck by motorized vehicle
   2. Fall >2m or 5ft
   3. Head struck by high-impact object
4. Severe headache

Then consider a Non-Con Brain CT or Observation (0.9% risk of cTBI)

^Consider observation in place of imaging in children with isolated vomiting (no other indication) as the sole risk factor (0.2% risk of cTBI)