Head_Injury_Pediatrics_Flashcards
What is a criterion for an immediate CT scan for a child with head injury related to loss of consciousness?
Loss of consciousness lasting more than 5 minutes (witnessed) is a criterion for an immediate CT scan.
What duration of amnesia (antegrade or retrograde) is a criterion for an immediate CT scan in pediatric head injury?
Amnesia (antegrade or retrograde) lasting more than 5 minutes is a criterion for an immediate CT scan.
Is abnormal drowsiness a criterion for an immediate CT scan in children with head injury?
Yes, abnormal drowsiness is a criterion for an immediate CT scan in children with head injury.
How many discrete episodes of vomiting warrant an immediate CT scan for a child with a head injury?
Three or more discrete episodes of vomiting warrant an immediate CT scan for a child with a head injury.
What clinical suspicion is a criterion for an immediate CT scan in pediatric head injury?
Clinical suspicion of non-accidental injury is a criterion for an immediate CT scan in pediatric head injury.
Does a post-traumatic seizure without a history of epilepsy require an immediate CT scan in children?
Yes, a post-traumatic seizure without a history of epilepsy requires an immediate CT scan in children.
What GCS score is a criterion for an immediate CT scan in children with head injury?
GCS less than 14, or for a baby under 1 year, GCS (paediatric) less than 15, on assessment in the emergency department.
What are signs of an open or depressed skull injury that necessitate an immediate CT scan in children?
Suspicion of open or depressed skull injury or tense fontanelle necessitates an immediate CT scan in children.
What are signs of a basal skull fracture that require an immediate CT scan in pediatric head injury?
Signs of basal skull fracture such as haemotympanum, panda’ eyes, cerebrospinal fluid leakage from the ear or nose, Battle’s sign require an immediate CT scan.
Does a focal neurological deficit warrant an immediate CT scan in children with head injury?
Yes, a focal neurological deficit warrants an immediate CT scan in children with head injury.
What head injuries in children under 1 year old require an immediate CT scan?
If under 1 year, the presence of bruise, swelling or laceration of more than 5 cm on the head requires an immediate CT scan.
What are dangerous mechanisms of injury that warrant an immediate CT scan for children with head injury?
Dangerous mechanisms of injury include high-speed road traffic accidents (as pedestrian, cyclist, or vehicle occupant), fall from a height greater than 3 m, high-speed injury from a projectile or an object.
summary of head injury paeds
Head injury paediatrics
Criteria for immediate request for CT scan of the head (children)
Loss of consciousness lasting more than 5 minutes (witnessed)
Amnesia (antegrade or retrograde) lasting more than 5 minutes
Abnormal drowsiness
Three or more discrete episodes of vomiting
Clinical suspicion of non-accidental injury
Post-traumatic seizure but no history of epilepsy
GCS less than 14, or for a baby under 1 year GCS (paediatric) less than 15, on assessment in the emergency department
Suspicion of open or depressed skull injury or tense fontanelle
Any sign of basal skull fracture (haemotympanum, panda’ eyes, cerebrospinal fluid leakage from the ear or nose, Battle’s sign)
Focal neurological deficit
If under 1 year, presence of bruise, swelling or laceration of more than 5 cm on the head
Dangerous mechanism of injury (high-speed road traffic accident either as pedestrian, cyclist or vehicle occupant, fall from a height of greater than 3 m, high-speed injury from a projectile or an object)
Which of the features below, following a head injury, is not an indication for an immediate CT head scan in children?
Drowsiness
A single, discrete episode of vomiting
A 9 month old child with a 6cm haematoma on the head
Numb left arm
Suspicion of a non accidental head injury
A single, discrete episode of vomiting
Whilst not an indication for immediate CT there should be a low threshold for admission and observation.
