To CT or not to CT, decision rule for children with head trauma at low risk for intracranial injury.

PECARN algorithm

** Severe mechanism is defined as:

AMS is defined as: agitation, somnolence, repetitive questioning, or slow response to verbal commands

Validated internally with > 8,600 patients, and externally twice with > 2400 patients combined. In all 3 trials, test was 100% sensitive for clinically significant findings.

Kuppermann N, et al. 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.

Schonfeld D, et al. Pediatric Emergency Care Applied Research Network head injury clinical prediction rules are reliable in practice. Arch Dis Child. 2014 May; 99(5):427-31.