CATCH | CHALICE | PECARN <2 years | PECARN ≥2 years |
---|---|---|---|
Mechanism of injury | |||
Dangerous mechanism of injury (eg MVC, fall from elevation ≥3 ft [≥0.91 m] or 5 stairs, fall from bicycle with no helmet). | High speed RTA as pedestrian, cyclist, occupant (>40 miles/h or >64 km/h). | Severe mechanism of injury (MVC with patient ejection, death of another passenger or rollover; pedestrian/bicyclist without helmet struck by motorized vehicle; falls >0.9 m; head struck by high impact object). | Severe mechanism of injury (MVC with patient ejection, death of another passenger or rollover; pedestrian/bicyclist without helmet struck by motorized vehicle; falls >1.5 m; head struck by high impact object). |
Fall of > 3 m in height. | |||
High speed injury from projectile or object. | |||
History | |||
Witnessed LOC > 5 min. | LOC ≥5 seconds. | Any/suspected LOC. | |
Amnesia (antegrade or retrograde) >5 min. | |||
Altered mental status. | Altered mental status. | ||
Not acting normally per parent. | |||
≥3 vomits after head injury (discrete episodes). | History of vomiting. | ||
Suspicion of NAI. | |||
Seizure in patient with no history of epilepsy. | |||
History of worsening headache. | Severe headache. | ||
Examination | |||
GCS <15, 2 hr after injury. | GCS <14, or <15 if <1 yr. | GCS < 15 | GCS < 15 |
Irritability on examination. | Abnormal drowsiness (in excess of that expected by examining doctor). | Other signs of altered mental status (agitation, somnolence, repetitive questioning, slow response to verbal communication) | Other signs of altered mental status (agitation, somnolence, repetitive questioning, slow response to verbal communication) |
Suspected open or depressed skull fracture. | Suspicion of penetrating or depressed skull injury, or tense fontanelle. | ||
Any sign of basal skull fracture (eg haemotympanum, “raccoon” eyes, otorrhoea/rhinorrhoea of CSF, Battle’s sign). | Signs of basal skull fracture. | Palpable or unclear skull fracture. | Clinical signs of basilar skull fracture. |
Positive focal neurology. | |||
Large boggy haematoma of the scalp. | Presence of bruise, swelling or laceration > 5 cm if < 1 yr old. | Occipital, parietal or temporal scalp haematoma. |