CATCH_childhood_head_injury_rule v.1
The clinical decision rule for the use of head CT-scan in children with minor head injury.
To provide interpretation of the clinical decision rule for the use of head CT-scan in children with minor head injury.
To be used in minor head injury cases on patients up to 16 years of age with the following criteria: - Initial GCS ≥13 on physician determination, - Injury within 24 hours, AND At least one of the following: - Blunt trauma to the head with witnessed loss of consciousness. - Definite amnesia. - Witnessed disorientation. - Vomiting two or more times at least 15 minutes apart. - Persistent irritability in a child under two years. CT of the head is required only for children with minor head injury* and any one of the following findings: High risk (need for neurologic intervention) - GCS <15 at two hours after injury. - Suspected open or depressed skull fracture. - History of worsening headache. - Irritability on examination. Medium risk (brain injury on CT scan) - Any sign of basal skull fracture (e.g., hemotympanum, “raccoon” eyes, otorrhea or rhinorrhea of the cerebrospinal fluid, Battle’s sign). - Large, boggy hematoma of the scalp. - Dangerous mechanism of injury (e.g., motor vehicle collision, fall from ≥3 ft (91 cm) or 5 stairs, fall from bicycle with no helmet).
Do not use in the presence of: - Penetrating skull injury. - Depressed fractures. - Acute focal neurological deficit. - Chronic generalized developmental delay. - Suspected child abuse. - Returning for re-evaluation after prior head injury. - Pregnant patients.
1. Osmond MH, Klassen TP, Wells GA, et al. CATCH: a clinical decision rule for the use of computed tomography in children with minor head injury. CMAJ. 2010;182(4):341-8. 2. Lyttle MD, Cheek JA, Blackburn C, et al. Applicability of the CATCH, CHALICE and PECARN paediatric head injury clinical decision rules: pilot data from a single Australian centre. Emerg Med J. 2013;30(10):790-4. 3. Lyttle MD, Crowe L, Oakley E, Dunning J, Babl FE. Comparing CATCH, CHALICE and PECARN clinical decision rules for pediatric head injuries. Emerg Med J. 2012;29(10):785–94. doi: 10.1136/emermed-2011-200225
OBSERVATION.glasgow_coma_scale.v1, OBSERVATION.catch_childhood_head_injury_rule.v0, EVALUATION.catch_childhood_head_injury_rule.v0
