EBQ:Canadian Head CT Rule: Difference between revisions
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| fulltexturl=http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(00)04561-X/fulltext | | fulltexturl=http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(00)04561-X/fulltext | ||
| pdfurl=http:// | | pdfurl=http://www.mcgill.ca/files/emergency/CCHR.pdf | ||
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==Major Points== | ==Major Points== | ||
The trial found that the following criteria had 100% sensitivity for identifying patient at risk for neurologic intervention with '''minor head injury''' | |||
#GCS score <15 at 2h post injury | |||
#Suspected open or depressed skull fracture | |||
#Any sign of basal skull fracture (hemotympanum, ‘racoon’ eyes, cerebrospinal fluid otorrhoea/rhinorrhoea, Battle’s sign) | |||
#Vomiting �≥ 2episodes | |||
#Age ≥ 65 years | |||
The moderate risk group (for brain injury on CT) was identified with 95% sensitivity if any of the following were present: | |||
#Amnesia before impact >30 min | |||
#Dangerous mechanism (pedestrian struck by motor vehicle, occupant ejected from motor vehicle, fall from height >3 feet or five stairs) | |||
*'''Minor head injury is defined as witnessed loss of consciousness, definite amnesia, or witnessed disorientation in a patients with a GCS score of 13–15 ''' | |||
==Design== | ==Design== | ||
Revision as of 16:19, 18 January 2014
incomplete Journal Club Article
Stiell IG, et al. "The Canadian CT Head Rule for patients with minor head trauma". The Lancet. 2001. 357(9266):1391-96.
PubMed Full text PDF
PubMed Full text PDF
Clinical Question
Can a decision rule be used to determine which patients require CT imaging after head trauma?
Conclusion
The Canadian CT head rule is a effective method for determining the need for a patient to receive a non contrast brain CT after head trauma.
Major Points
The trial found that the following criteria had 100% sensitivity for identifying patient at risk for neurologic intervention with minor head injury
- GCS score <15 at 2h post injury
- Suspected open or depressed skull fracture
- Any sign of basal skull fracture (hemotympanum, ‘racoon’ eyes, cerebrospinal fluid otorrhoea/rhinorrhoea, Battle’s sign)
- Vomiting �≥ 2episodes
- Age ≥ 65 years
The moderate risk group (for brain injury on CT) was identified with 95% sensitivity if any of the following were present:
- Amnesia before impact >30 min
- Dangerous mechanism (pedestrian struck by motor vehicle, occupant ejected from motor vehicle, fall from height >3 feet or five stairs)
- Minor head injury is defined as witnessed loss of consciousness, definite amnesia, or witnessed disorientation in a patients with a GCS score of 13–15