Head CT (Canadian Rule): Difference between revisions
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##Fall from elevation >3 feet or 5 stairs | ##Fall from elevation >3 feet or 5 stairs | ||
==Canadian rule vs. New Orleans vs. Nexus II rules== | ==Canadian rule vs. [[Head CT (New Orleans Rule)|New Orleans]] vs. Nexus II rules== | ||
Comparison done to evaluate Sensitivity and Specificity for clinically important intracranial injuries | Comparison done to evaluate Sensitivity and Specificity for clinically important intracranial injuries | ||
===Sensitivity=== | ===Sensitivity=== | ||
Revision as of 03:07, 20 April 2012
Canadian CT Head Rule
Not applicable for non-trauma, GCS<13, Age <16, Bleeding disorder or on anti-coagulation (e.g. Coumaidn, Debigatran), Obvious open skull fracture.
If ANY High Risk factor present – then get a CT Head
- Age >65 years
- Suspected Open or Depressed skull fracture
- Signs suggesting Basal skull fracture
- Hemotympanum
- Racoon eyes
- CSF otorrhea or rhinorrhea
- Battle sign
- Vomiting > 2 times
- GCS <15 at 2 hours post injury
If ANY Medium Risk factor present – then get a CT Head
- Amnesia before impact >30min
- Dangerous mechanism
- Pedestrian struck by vehicle
- Ejection from motor vehicle
- Fall from elevation >3 feet or 5 stairs
Canadian rule vs. New Orleans vs. Nexus II rules
Comparison done to evaluate Sensitivity and Specificity for clinically important intracranial injuries
Sensitivity
Canadian 99% vs New Orleans 99% vs. Nexus II 97%
Specificity
Canadian 47% vs. New Orleans 33% vs. Nexus II 47%
Source
- Ann of Emerg Med 2009; 53, 2:180-188.
- http://www.ohri.ca/emerg/cdr/cthead.html