PECARN Pediatric Head Injury/Trauma Algorithm
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GCS ≤14, palpable skull fracture or signs of AMS
AMS: Agitation, somnolence, repetitive questioning, or slow response to verbal communication |
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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 |
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GCS ≤14 or signs of basilar skull fracture or signs of AMS
AMS: Agitation, somnolence, repetitive questioning, or slow response to verbal communication |
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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 |
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Result :
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References
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Kuppermann N, Holmes JF, Dayan PS, Hoyle JD Jr, Atabaki SM, Holubkov R, Nadel FM, Monroe D, Stanley RM, Borgialli DA, Badawy MK, Schunk JE, Quayle KS, Mahajan P, Lichenstein R, Lillis KA, Tunik MG, Jacobs ES, Callahan JM, Gorelick MH, Glass TF, Lee LK, Bachman MC, Cooper A, Powell EC, Gerardi MJ, Melville KA, Muizelaar JP, Wisner DH, Zuspan SJ, Dean JM, Wootton-Gorges SL; Pediatric Emergency Care Applied Research Network (PECARN). 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. doi: 10.1016/S0140-6736(09)61558-0. Epub 2009 Sep 14. Erratum in: Lancet. 2014 Jan 25;383(9914):308.
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