SAQ 222 – Trauma – adult and paediatric head-injury CT criteria

Question 2. adult and paediatric head-injury CT criteria.

a. Adult urgent CT criteria

• GCS below 13 on arrival.
• GCS below 15 at two hours.
• Suspected open or depressed skull fracture.
• Signs of basal skull fracture.
• Post-traumatic seizure.
• Focal neurological deficit.
• Vomiting.

b. Adult semi-urgent CT criteria

• Loss of consciousness or amnesia with age 65 years or older.
• Loss of consciousness or amnesia with a bleeding or clotting disorder.
• Loss of consciousness or amnesia with dangerous mechanism.
• Loss of consciousness or amnesia with more than 30 minutes of retrograde amnesia.

c. Paediatric variations

• Suspicion of non-accidental injury.
• GCS below 14, or below 15 in a child under one year.
• Tense fontanelle.
• In a child under one year, scalp bruise, swelling, or laceration larger than 5 cm.
• Two or more of: three or more vomiting episodes, loss of consciousness over five minutes, dangerous mechanism, abnormal drowsiness, or amnesia over five minutes.