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''Rules below are according to the of PECARN Head CT Study<ref>[[EBQ:PECARN_Pediatric_Head_CT_Rule|PECARN Rule]] Kupperman N, Holmes JF, Dayan PS, et al: Identification of children at very low risk of clinically-important brain injuries after head trauma: a prospective cohort study. Lancet 374(9696): 1160, 2009</ref>'' | ''Rules below are according to the of [[EBQ:PECARN_Pediatric_Head_CT_Rule|PECARN Head CT Study]]<ref>[[EBQ:PECARN_Pediatric_Head_CT_Rule|PECARN Rule]] Kupperman N, Holmes JF, Dayan PS, et al: Identification of children at very low risk of clinically-important brain injuries after head trauma: a prospective cohort study. Lancet 374(9696): 1160, 2009</ref>'' | ||
===<2 years old=== | ===<2 years old=== | ||
[[File:PECARN Under Age 2.jpg|thumb|PECARN Under Age 2]] | [[File:PECARN Under Age 2.jpg|thumb|PECARN Under Age 2]] | ||
Revisión del 17:05 13 sep 2018
Rules below are according to the of PECARN Head CT Study[1]
<2 years old
Any 1 of the following?
- GCS ≤14
- Altered Mental Status
- Palpable Skull Fracture
Then obtain a Non-Con Brain CT (4.4% risk of cTBI)
1 or more of the following?
- Non-frontal scalp hematoma
- LOC ≥ 5 seconds
- Severe injury mechanism
- pedestrian or bicyclist without helmet struck by motorized vehicle
- fall >1m or 3ft
- head struck by high-impact object
- 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?
- GCS ≤14
- Altered Mental Status
- Signs of a basilar skull fracture
Then obtain a Non-Con Brain CT (4.3% risk of cTBI)
1 or more of the following?
- History of vomiting^
- LOC
- Severe injury mechanism
- Pedestrian or bicyclist without helmet struck by motorized vehicle
- Fall >2m or 5ft
- Head struck by high-impact object
- 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)[2]
- ↑ PECARN Rule Kupperman N, Holmes JF, Dayan PS, et al: Identification of children at very low risk of clinically-important brain injuries after head trauma: a prospective cohort study. Lancet 374(9696): 1160, 2009
- ↑ Dayan PS, et al. "Association of Traumatic Brain Injuries with Vomiting in Children with Blunt Head Trauma. June 2014. Annals of EM. 63(6):657-665