Minor Head Injury
Guideline · Oct 2018 · 1 min read
In brief
In brief
Clinical guideline for managing minor head injuries (GCS 13-15) in pediatric trauma patients at CCHMC. Incorporates adapted PECARN decision rule to identify children at very low risk of clinically-important brain injuries, guiding appropriate imaging and disposition decisions.
- Minor head injury defined as Glasgow Coma Score 13-15, requiring systematic primary and secondary survey assessment.
- PECARN decision rule adapted for pediatric emergency use to identify very low-risk children who can avoid CT imaging.
- Standardized flow diagram guides clinical decision-making to reduce unnecessary radiation exposure in pediatric head trauma.
- Evidence-based approach identifies clinically-important brain injuries while minimizing imaging in low-risk patients.
Written by the GCMD Library team from the guideline.
1.0 SCOPE
- Care of the Trauma Services patient at CCHMC.
2.0 DEFINITIONS
- Minor head injury: Glasgow Coma Score (GCS) 13 - 15
3.0 GUIDELINE
- Complete primary and secondary survey per guidelines.
Refer to Minor head injury flow diagram next page
4.0 REFERENCES
- Bressan, S, Romanato, S, Mion, T, Zanconato, S, & Dalt, LD. (2012). Implementation of adapted PECARN decision rule for children with minor head injury in the pediatric emergency department. Academic Emergency Medicine, 19, 801-807
- Kuppermann, N, Holmes, JF, Dayan, PS, Hoyle, JD, et al.. (2009). Identification of children at very low risk of clinically-important brain injuries after head trauma: A prospective cohort study. Lancet, 374, 1160-1170.
5.0 APPROVALS
All revisions of this guideline are approved by the Trauma Service Department. This guideline is reviewed every three
years or sooner if deemed necessary. Policy authority for this document resides with the Trauma Service Department.
This guideline is approved by the Trauma Services Manager and the Director of Trauma Services.
Statements in this guideline
Minor head injury is defined as Glasgow Coma Score 13 to 15.
Complete primary and secondary survey per guidelines for all trauma patients.
Refer to the Minor head injury flow diagram for management decisions.
The adapted PECARN decision rule is used for children with minor head injury in the pediatric emergency department.
This guideline lives on trauma.pemcincinnati.com.
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