CT head indications Flashcards
An adult who has sustained a head injury presents to the ED. What risk factors should you look out for to determine whether they will need a CT head urgently?
GCS < 13 on IA
GCS < 15 at 2 hours after injury on assessment in the ED
Suspected open or depressed skull fracture
Any sign of basal skull fracture
Post-traumatic seizure
Focal neurological deficit
More than one episode of vomiting since head injury?
The adult presenting to ED has a GCS < 13 on IA (or any other of the risk factors you have identified as needing urgent CT head). How quickly should the CT head be performed?
Within 1 hour of the risk factor being identified
How quickly should the radiology report be made available after doing a CT head?
Within 1 hour of CT head taking place
If the patient does not have any of the risk factors suggesting urgent CT head is required, what other factors should be considered?
Current anticoagulation Tx
If the patient is on current anticoagulation Tx how quickly should the CT head be done?
Within 8 hours of head injury
A patient is not on anticoagulation Tx, but has had LOC/amnesia since the head injury. What other risk factors should you be looking for? If these risk factors are present how quickly should CT head be done?
Age > 65 years
Hx of bleeding or clotting disorder
Dangerous mechanism or injury (e.g., pedestrian or cyclist getting hit by a motor vehicle, someone being ejected from a motor vehicle, or a fall from a height of > 1 m or 5 stairs)
More than 30 minutes of retrograde amnesia immediately before the head injury
CT head within 8 hours of head injury
If the patient is not on anticoagulants and has no LOC or amnesia since the head injury, do you need a CT head?
No
If the patient is not on anticoagulants but has had LOC or amnesia since the head injury with no other risk factors, do you need a CT head?
No
