PECARN pediatric head injury rule
Risk of clinically important brain injury and CT decision in children with minor head trauma.
Inputs
0 of 1Age
GCS 14 or other signs of altered mental status
Palpable skull fracture (under 2) or signs of basilar skull fracture (2 or older)
Loss of consciousness (≥ 5 s under 2; any if 2 or older)
Severe mechanism of injuryMotor vehicle crash with ejection, death, or rollover; pedestrian or unhelmeted cyclist struck; fall over 3 ft (under 2) or 5 ft (2 or older); head struck by high-impact object.
Under 2: nonfrontal scalp hematoma, or not acting normally per parent. 2 or older: vomiting, or severe headache
When to use
- Children with GCS 14–15 within 24 hours of head trauma.
Pearls and pitfalls
- Intermediate risk: choose CT versus observation by physician experience, multiple findings, worsening symptoms, age under 3 months, and parental preference.
Why use
The most validated pediatric head CT rule.
Age-specific high-risk and intermediate-risk predictors