PECARN v.0
CT imaging is often used to diagnose traumatic brain injuries (TBI) in emergency settings. However, TBIs identified on CT imaging may be non-traumatic, false positives, or they may not require emergent intervention. It is important to reduce the use of CT imaging in children as the radiation from CT scans can cause lethal malignancies. The PECARN Pediatric Head Injury/Trauma Algorithm identifies children at very low risk of clinically-important traumatic brain injury (ciTBI).
The purpose of this algorithm is to identify children who present with a very low risk of clinically-important traumatic brain injuries (ciTBI). CT imaging may not be required in this group of children.
The algorithm is used for children younger than 18 years old. It consists of 2 prediction rules. Children younger than 2 years are considered low-risk if they have normal mental status, no scalp haematoma except frontal, no loss of consciousness or loss of consciousness for less than 5 seconds, non-severe injury mechanism, no palpable skill fracture, and are acting normally according to parents. Hence, CT imaging is not recommended for this group. Children 2 years and older are considered low-risk if they have normal mental status, no loss of consciousness, no vomiting, non-severe injury mechanism, no signs of basilar skull feature and no severe headache. Hence, CT imaging is not recommended for this group.
The algorithm should not be used for patients 18 years and older.
[1] Kuppermann N, Holmes JF, Dayan PS, Hoyle JD Jr, Atabaki SM, Holubkov R et al. Identification of children at very low risk of clinically-important brain injuries after head trauma: a prospective cohort study. Lancet. 2009 Oct 3;374(9696):1160-70. [2] Pickering A, Harnan S, Fitzgerald P, et al Clinical decision rules for children with minor head injury: a systematic reviewArchives of Disease in Childhood 2011;96:414-421.
openEHR-EHR-OBSERVATION.basic_demographic, openEHR-EHR-OBSERVATION.pecarn_pediatric_head_injury_trauma_algorithm, openEHR-EHR-EVALUATION.recommendation_pecarn_pediatric_head_injury
