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    Patent Pending

    CATCH (Canadian Assessment of Tomography for Childhood Head injury) Rule

    Predicts clinically significant head injuries in children.

    INSTRUCTIONS

    Use in patients up to 16 yrs with minor head injury and initial GCS at least 13, injury within 24 hrs, plus at least one of the following: blunt trauma with witnessed LOC, amnesia, witnessed disorientation, vomiting 2+ times at least 15 mins apart, persistent irritability if under 2 years old. Do NOT use if: penetrating skull injury, depressed fx, focal neuro deficit, developmental delay, child abuse, re-eval after prior head injury, pregnant patient. Note: We recommend using PECARN, as it is more widely validated.

    When to Use
    Pearls/Pitfalls
    Why Use

    Pediatric patients up to 16 years old with minor head injury and:

    • Initial GCS ≥13 on physician determination,
    • Injury within 24 hours, AND
    • At least one of the following:
      • Blunt trauma to the head with witnessed loss of consciousness.
      • Definite amnesia.
      • Witnessed disorientation.
      • Vomiting two or more times at least 15 minutes apart.
      • Persistent irritability in a child under two years.

    Do not use in any of the following situations:

    • Penetrating skull injury.
    • Depressed fractures.
    • Acute focal neurological deficit.
    • Chronic generalized developmental delay.
    • Suspected child abuse.
    • Returning for re-evaluation after prior head injury.
    • Pregnant patients.
    • Identifies high risk patients with specific signs and symptoms.
    • Generalizability is limited, as it uses numerous strict inclusion and exclusion criteria.
    • Less sensitive than the PECARN Algorithm.
    • Original study included detailed sensitivity analysis for combinations of risk factors, perhaps giving a more nuanced approach to the decision to obtain CT.
    • Intoxicated patients were not excluded, making GCS estimation potentially unreliable.

    Original study included detailed sensitivity analysis for combinations of risk factors, perhaps giving a more nuanced approach to the decision to obtain CT.

    No
    Yes
    No
    Yes
    No
    Yes
    No
    Yes
    No
    Yes
    No
    Yes
    No
    Yes

    Result:

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    Next Steps
    Evidence
    Creator Insights
    Dr. Martin H. Osmond

    About the Creator

    Martin H. Osmond, MD, is a pediatric emergency physician at the Children’s Hospital of Eastern Ontario (CHEO). He is also the CEO and scientific director of the CHEO Research Institute. Dr. Osmond’s areas of research interest are the evaluation and management of pediatric head injuries and the use of pre-hospital care in the treatment of ill and injured children.

    To view Dr. Martin H. Osmond's publications, visit PubMed

    Are you Dr. Martin H. Osmond? Send us a message to review your photo and bio, and find out how to submit Creator Insights!
    MDCalc loves calculator creators – researchers who, through intelligent and often complex methods, discover tools that describe scientific facts that can then be applied in practice. These are real scientific discoveries about the nature of the human body, which can be invaluable to physicians taking care of patients.
    Content Contributors
    • Diana Fleisher, MD
    About the Creator
    Dr. Martin H. Osmond
    Are you Dr. Martin H. Osmond?
    Content Contributors
    • Diana Fleisher, MD