Head CT (Peds)

< 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- 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%

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

Physician experience

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