Calc Function

    • Calcs that help predict probability of a diseaseDiagnosis
    • Subcategory of 'Diagnosis' designed to be very sensitiveRule Out
    • Disease is diagnosed: prognosticate to guide treatmentPrognosis
    • Numerical inputs and outputsFormula
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    New Orleans/Charity Head Trauma/Injury Rule

    Criteria for which patients are unlikely to require imaging after head trauma.
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    BEFORE USE

    Use ONLY in head injury patients who are neurologically normal (GCS 15 and normal brief neurological exam).

    When to Use
    Pearls/Pitfalls
    Why Use

    Result:

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    Next Steps
    Evidence
    Creator Insights

    Advice

    • Consider CT Head pending outcome of the rule.
    • Consider Neurosurgery Consult as per rule guidelines.

    Management

    In patients with signs of intracranial hemorrhage, contusion, skull fracture, or other abnormalities diagnosed on brain imaging:

    • Always assess ABCs first.
    • Neurosurgery consultation.
    • Consider hypertonic saline or mannitol after consultation with neurosurgery.
    • Admit to neurosurgical ICU for monitoring and further care.

    Critical Actions

    • Providers in more conservative settings could consider applying both rules and choosing to image if either rule suggests that a patient is not completely low risk according to their respective criteria.
    • If a trauma patient, with a head injury and loss of consciousness, presenting with a GCS 15 is positive for any of the NOC (age >60, headache, vomiting, alcohol or drug intoxication, persistent anterograde amnesia, visible trauma above the clavicle or seizures) then they require a CT scan of the head to evaluate for intracranial injury.
    • If the patient does not have any of the NOC then they can be discharged without undergoing a CT of the head and without the need for any further clinical observation.
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