Head CT (Peds): Difference between revisions

(Created page with "==< 2 yr old- no CT if all below negative== AMS Scalp hematoma (parietal, occipital, temporal, excluding frontal) LOC > 5sec Severe mechanism of injury Palpable or unclear ...")
 
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==< 2 yr old- no CT if all below negative==
==< 2 yr old==
===no CT if all below negative===
#AMS
#Scalp hematoma (parietal, occipital, temporal, excluding frontal)
#LOC > 5sec
#Severe mechanism of injury
#Palpable or unclear skull fracture
#Acting normal per parent


 
==> 2 yr old==
AMS
===no CT if all below negative===
 
#AMS
Scalp hematoma (parietal, occipital, temporal, excluding frontal)
#LOC
 
#History of vomiting
LOC > 5sec
#Severe mechanism of injury
 
#Clinical signs of basilar skull fracture
Severe mechanism of injury
#Severe headache
 
Palpable or unclear skull fracture
 
Acting normal per parent
 
 
==> 2 yr old- no CT if all below negative==
 
 
AMS
 
LOC
 
History of vomiting
 
Severe mechanism of injury
 
Clinical signs of basilar skull fracture
 
Severe headache
 


NPV > 99%  PPV > 99%
NPV > 99%  PPV > 99%


==Treatment==
 
If any (except AMS or e/o fracture) are positive, may consider period of observation vs CT depending on:
If any (except AMS or e/o fracture) are positive, may consider period of observation vs CT depending on:
 
#Physician experience
Physician experience
#Parental preference
 
Parental preference
 
== ==
 


==See Also==
==See Also==
Peds: Head Trauma (Peds)
Peds: Head Trauma (Peds)


Line 60: Line 36:


Trauma: Head Trauma (Adult)
Trauma: Head Trauma (Adult)


==Source==
==Source==
PECARN- Kupperman 2009
PECARN- Kupperman 2009


[[Category:Peds]]
[[Category:Peds]]

Revision as of 18:38, 7 June 2011

< 2 yr old

no CT if all below negative

  1. AMS
  2. Scalp hematoma (parietal, occipital, temporal, excluding frontal)
  3. LOC > 5sec
  4. Severe mechanism of injury
  5. Palpable or unclear skull fracture
  6. Acting normal per parent

> 2 yr old

no CT if all below negative

  1. AMS
  2. LOC
  3. History of vomiting
  4. Severe mechanism of injury
  5. Clinical signs of basilar skull fracture
  6. Severe headache

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

Peds: Head Trauma (Peds)

Peds: GCS (Peds)

Peds: Concussion

Peds: Skull Fracture

Peds: Abuse (Nonaccidental Trauma)

Trauma: Head Trauma (Adult)

Source

PECARN- Kupperman 2009