Head CT (Peds): Difference between revisions
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==< 2 yr old== | ==< 2 yr old== | ||
===no CT if all below negative=== | ===no CT if all below negative=== | ||
#AMS | #AMS (GCS ≥14) | ||
#Scalp hematoma ( | #Scalp hematoma (frontal hematoma is ok) | ||
#LOC > 5sec | #LOC > 5sec | ||
#Palpable | #Palpable skull fracture | ||
#Acting normal per parent | #Acting normal per parent | ||
#Severe mechanism of injury | #Severe mechanism of injury | ||
| Line 14: | Line 14: | ||
==> 2 yr old== | ==> 2 yr old== | ||
===no CT if all below negative=== | ===no CT if all below negative=== | ||
#AMS | #AMS (GCS ≥14) | ||
#LOC | #LOC | ||
#History of vomiting | #History of vomiting | ||
Revision as of 13:18, 5 July 2011
< 2 yr old
no CT if all below negative
- AMS (GCS ≥14)
- Scalp hematoma (frontal hematoma is ok)
- LOC > 5sec
- Palpable skull fracture
- Acting normal per parent
- Severe mechanism of injury
- Fall >3ft (>0.9m)
- Head struck by high-impact object
- MVC w/ pt ejection, death of passenger, or rollover
- Pedestrian or bicyclist struck by motorized vehicle
> 2 yr old
no CT if all below negative
- AMS (GCS ≥14)
- LOC
- History of vomiting
- Clinical signs of basilar skull fracture
- Severe headache
- Severe mechanism of injury
- Fall >5ft (>1.5m)
- Head struck by high-impact object
- MVC w/ pt ejection, death of passenger, or rollover
- 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:
- Physician experience
- Parental preference
See Also
Source
PECARN- Kupperman 2009