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
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 vomitting
2. LOC
3. Severe injury mechanism
4. Severe headache

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

< 2yr old

• No CT is necessary if ALL are found:

1. Normal mental status
2. No scalp hematoma except frontal
   1. LOC <5s
3. Non-severe mechanism
   1. Severe mechanism = pedestrian or bicyclist w/o helmet struck by motorized vehicle
   2. Severe mechanism = fall >1m or 3ft
   3. Severe mechanism = head struck by high-impact object
4. No palpable skull fracture
5. Normal behavior per parents

>2yr old

• No CT is necessary if ALL are found:

1. Normal mental status
2. No LOC
3. No vomiting
4. Non-severe mechanism:
   1. Severe mechanism = pedestrian or bicyclist w/o helmet struck by motorized vehicle
   2. Severe mechanism = fall >2m or 5ft
   3. Head struck by high-impact object
5. No signs of basilar skull fracture
6. No severe headache