Guidelines

Question 1

Indications for CT head within 1 hr of head injury

Answer 1

• GCS 12 or less on initial assessment

• GCS <15 at 2 hours post-injury

• Suspected open, depressed or basal skull fracture

• Seizure

• Focal neurological deficit

• >1 episode of vomiting

Question 2

Indications for CT head within 8 hours of head injury

Answer 2

• 65 or over

• Bleeding or clotting disorders

• Dangerous mechanism eg RTC, fall from a height of more than 1 m or 5 stairs

• >30 minutes retrograde amnesia

Question 3

Indications for CT head within 1 hr of head injury in a child (<16 yrs)

Answer 3

• Suspected NAI
• Seizure
• GCS 13 or less or, if under 1 year, GCS <15
• GCS <15 at 2 hrs post-injury
• Suspected open, depressed or basal skull fracture, or tense fontanelle
• Focal neurological deficit
• For babies <1 year, a bruise, swelling or laceration of more than 5 cm on the head.

OR

2 of the following:
• LOC >5 minutes (witnessed)
• Abnormal drowsiness
• 3 or more episodes of vomiting
• Dangerous mechanism of injury
• Amnesia (anterograde or retrograde) lasting more than 5 minutes
• Any current bleeding or clotting disorder