|
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| Line 1: |
Line 1: |
| ==< 2 yr old==
| | #Redirect[[Head Trauma (Peds)]] |
| ===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
| |
| ===CT if either of the following===
| |
| #AMS
| |
| #Evidence of skull fracture
| |
| ===CT versus observation===
| |
| If any (except AMS or e/o fracture) are positive, obs vs CT depending on:
| |
| #physician experience
| |
| #multiple versus isolated findings
| |
| #worsening symptoms after ED obs
| |
| #age <3 months
| |
| #parental preference
| |
| | |
| ==> 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
| |
| ===CT if either of the following===
| |
| #AMS
| |
| #Signs of basilar skull fracture
| |
| ===CT versus observation===
| |
| If any (except AMS or e/o fracture) are positive, obs vs CT depending on:
| |
| #physician experience
| |
| #multiple versus isolated findings
| |
| #worsening symptoms or signs after ED obs
| |
| #parental preference
| |
| | |
| NPV > 99% PPV > 99%
| |
| | |
| ==See Also==
| |
| [[Head Trauma (Minor) (Peds)]] | |
| | |
| [[GCS (Peds)]]
| |
| | |
| [[Concussion]]
| |
| | |
| [[Skull Fracture]]
| |
| | |
| [[Abuse (Nonaccidental Trauma)]]
| |
| | |
| [[Head Trauma (Adult)]]
| |
| | |
| ==Source==
| |
| PECARN- Kupperman 2009
| |
|
| |
|
| [[Category:Peds]] | | [[Category:Peds]] |
| [[Category:Trauma]] | | [[Category:Trauma]] |
