Title: PECARN Head Injury Rule<br/>Author: Rose Chasm<br/><a href='http://umem.org/profiles/faculty/82/'>[Click to email author]</a><hr/><p>
Clinically important traumatic brain injuries are rare in children. The PECARN study provides decision rules for when to avoid unnecessarily obtaining a CT for children who have suffered head trauma.</p>
<p>
For children < 2 years old: <0.02% risk of clinically important TBI</p>
<ul>
<li>
Normal mental status</li>
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No scalp hematoma, except frontal</li>
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Loss of consciousness < 5 seconds</li>
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No palpalble skull fracture</li>
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Normal behavior</li>
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Nonsevere mechanism (fall < 3ft, pedestrian struck, rollover MVC)</li>
</ul>
<p>
For children > 2 years old: <0.05% risk of clinically important TBI</p>
<ul>
<li>
Normal mental status</li>
<li>
No signs of basilar skull fracture</li>
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No loss of consciousness</li>
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No vomiting</li>
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No severe headache</li>
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Nonsever mechanism (fall < 5ft, pedestrian struck, rollover MVC)</li>
</ul>
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</p>
<fieldset><legend>References</legend>
<p>
Kuppermann N, et al. Pediatric Emergency Care Applied Research Network. Identification of childrent at very low risk of clinically-important brain injuries after head trauma: a prospective cohort study. Lancet 2009 Oct 3;374(9696):1160-70.</p>
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