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head_injury_paed

paediatric head injury

see also:

NICE 2014 indications for head CT scan within 1 hour

if ONE or MORE of

  • suspicion of NAI
  • post-traumatic seizure and no PH epilepsy
  • GCS < 14 on arrival (<15 if < 1 yr old)
  • GCS < 15 at 2hrs
  • signs of base of skull #
  • focal neurology
  • suspected open # or depressed skull #
  • tense fontanelle
  • swelling / bruise / laceration > 5cm in those under 1 yr old
  • on warfarin (scan can be delayed up to 8hrs??)

or MORE THAN ONE of

  • witnessed LOC > 5 min
  • abnormal drowsiness
  • > 3 discrete vomiting episodes
  • dangerous mechanism such as pedestrian, cyclist, vehicle occupant, fall > 3m, high speed injury from projectile or other object
  • retrograde or anterograde amnesia > 5 min

references

1)
JAMA Neurology 2016. Brophy G, Welch R, Papa L, et al. Time Course and Diagnostic Accuracy of Glial and Neuronal Blood Biomarkers GFAP and UCH-L1 in a Large Cohort of Trauma Patients With and Without Mild Traumatic Brain Injury.
head_injury_paed.txt · Last modified: 2016/03/30 21:21 by gary1