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

    Predicts clinically significant head injuries in children.
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    INSTRUCTIONS

    Use in patients with head injury ≤24 hrs ago associated with witnessed LOC, definite amnesia, witnessed disorientation, persistent vomiting (>1 episode) or persistent irritability (in a child under 2 years of age) with GCS 13–15. Note: We recommend using PECARN over other pediatric head trauma rules, as it is the most widely validated.

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    Formula

    CT of the head is required only for children with minor head injury* and any one of the following findings:

    High risk (need for neurologic intervention)

    • GCS <15 at two hours after injury.
    • Suspected open or depressed skull fracture.
    • History of worsening headache.
    • Irritability on examination.

    Medium risk (brain injury on CT scan)

    • Any sign of basal skull fracture (e.g., hemotympanum, “raccoon” eyes, otorrhea or rhinorrhea of the cerebrospinal fluid, Battle’s sign).
    • Large, boggy hematoma of the scalp.
    • Dangerous mechanism of injury (e.g., motor vehicle collision, fall from ≥3 ft (91 cm) or 5 stairs, fall from bicycle with no helmet).

    *Minor head injury is defined as injury within the past 24 hours associated with witnessed loss of consciousness, definite amnesia, witnessed disorientation, persistent vomiting (more than one episode) or persistent irritability (in a child <2 years) with GCS 13–15.

    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 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