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Calculators /
PECARN pediatric head injury/trauma algorithm

Age
GCS ≤14, palpable skull fracture or signs of AMS

AMS: Agitation, somnolence, repetitive questioning, or slow response to verbal communication
History of LOC or history of vomiting or severe headache or severe mechanism of injury

Motor vehicle crash with patient ejection, death of another passenger, or rollover; pedestrian or bicyclist without helmet struck by a motorized vehicle; falls of more than 1.5m/5ft; head struck by a high-impact object
Occipital, parietal or temporal scalp hematoma; history of LOC ≥5 sec; not acting normally per parent or severe mechanism of injury?

Severe mechanism: MVC with patient ejection, death of another passenger, rollover; pedestrian or bicyclist w/o helmet struck by motorized vehicle; fall from >0.9m or 3ft; head struck by high-impact object
Result : 0
Result : 0
Node Recommendation

PECARN recommends obtaining a CT.  

There is a greater than 4% risk of clinically important traumatic brain injury (ciTBI)

Node Recommendation

PECARN recommends against a CT. 

Risk of ciTBI is < 0.02%

Node Recommendation

PECARN recommends observation instead of imaging, though this depends on the provider's discretion. 

Risk of ciTBI 0.9%

Node Recommendation

PECARN recommends against a CT. 

Risk of ciTBI is < 0.05%

Node Recommendation

PECARN recommends observation instead of imaging, although this depends on the the provider's discretion. 

Risk of ciTBI is 0.9%