MDCalc

Palchak (UC Davis) Rule for Pediatric Head Trauma

Identifies children at low risk for brain injuries after blunt head trauma.

Note: We recommend using PECARN over other pediatric head trauma rules, as it is the most widely validated.

Abnormal mental status

Result:

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Advice
  • This tool should be used in conjunction with clinical judgment. 
  • A thorough evaluation is essential, and factors such as non-accidental trauma or high-impact injury mechanisms require individual consideration.
Management
  • Low-risk cases: 
    • Consider observation instead of immediate imaging.
    • If imaging is deferred, ensure caregiver education and appropriate follow-up.
  • Elevated-risk cases: If one or more high-risk criteria are met, head CT should be strongly considered.