Interactive PECARN Pediatric Head Injury/CT decision rule calculator. Requires the calculator gadget.
Usage: {{PECARN Calculator}}
PECARN Pediatric Head Injury
PECARN — Pediatric Head CT Decision Rule
| Age Group
|
Select One
|
| Patient Age
|
1 <2 years ≥2 years
|
Age <2 Years — Risk Factors
| Criteria
|
No
|
Yes
|
| GCS <15 (altered mental status)
|
1
|
|
| Palpable skull fracture
|
1
|
|
| Occipital/parietal/temporal scalp hematoma
|
1
|
|
| Loss of consciousness ≥5 seconds
|
1
|
|
| Not acting normally per parent
|
1
|
|
| Severe mechanism of injury (MVC with ejection/rollover/fatality, pedestrian/cyclist without helmet struck by motorized vehicle, fall >3 feet, head struck by high-impact object)
|
1
|
|
| Risk Factors (<2y)
|
/ 6
|
Age ≥2 Years — Risk Factors
| Criteria
|
No
|
Yes
|
| GCS <15 (altered mental status)
|
1
|
|
| Signs of basilar skull fracture (hemotympanum, raccoon eyes, Battle sign, CSF otorrhea/rhinorrhea)
|
1
|
|
| Vomiting
|
1
|
|
| Loss of consciousness
|
1
|
|
| Severe headache
|
1
|
|
| Severe mechanism of injury (MVC with ejection/rollover/fatality, pedestrian/cyclist without helmet struck by motorized vehicle, fall >5 feet, head struck by high-impact object)
|
1
|
|
| Risk Factors (≥2y)
|
/ 6
|
| Interpretation (for selected age group)
|
| 0
|
Very low risk — ciTBI risk <0.02% (<2y) or <0.05% (≥2y). CT not recommended.
|
| 1 (intermediate*)
|
Low risk — ciTBI risk ~0.9% (<2y) or ~0.8% (≥2y). Observation vs. CT. *Only if GCS=15 and no skull fracture/AMS. Consider observation for 4-6 hours.
|
| GCS<15 or skull fx
|
High risk — ciTBI risk 4.4% (<2y) or 4.3% (≥2y). CT recommended.
|
| References
|
- Kuppermann N, Holmes JF, Dayan PS, et al. Identification of children at very low risk of clinically-important brain injuries after head trauma: a prospective cohort study. Lancet. 2009;374:1160-1170. PMID 19758692.
|
