Head CT (Peds)

< 2 yr old

no CT if all below negative

1. AMS
2. Scalp hematoma (parietal, occipital, temporal, excluding frontal)
3. LOC > 5sec
4. Palpable or unclear skull fracture
5. Acting normal per parent
6. Severe mechanism of injury
   1. Fall >3ft (>0.9m)
   2. Head struck by high-impact object
   3. MVC w/ pt ejection, death of passenger, or rollover
   4. Pedestrian or bicyclist struck by motorized vehicle

> 2 yr old

no CT if all below negative

1. AMS
2. LOC
3. History of vomiting
4. Clinical signs of basilar skull fracture
5. Severe headache
6. Severe mechanism of injury
   1. Fall >5ft (>1.5m)
   2. Head struck by high-impact object
   3. MVC w/ pt ejection, death of passenger, or rollover
   4. Pedestrian or bicyclist struck by motorized vehicle

NPV > 99% PPV > 99%

Treatment

If any (except AMS or e/o fracture) are positive, may consider period of observation vs CT depending on:

1. Physician experience
2. Parental preference

See Also

Head Trauma (Minor) (Peds)

GCS (Peds)

Concussion

Skull Fracture

Abuse (Nonaccidental Trauma)

Head Trauma (Adult)

Source

PECARN- Kupperman 2009