Head CT (Peds)

< 2 yr old

no CT if all below negative

1. AMS (GCS ≥14)
2. Scalp hematoma (frontal hematoma is ok)
3. LOC > 5sec
4. Palpable 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 (GCS ≥14)
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