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PECARN Pediatric Head Injury/Trauma Algorithm

Predicts need for brain imaging after pediatric head injury.

Note: This only applies to children with GCS scores of 14 or greater.

Advice

  • In patients with suspected or radiologically-confirmed TBI, first assess ABC’s and consider neurosurgical/ICU consultation or local policies in regards to fluid management, seizure prophylaxis, hypertonic saline/mannitol, disposition, etc.
  • Observation for 4-6 hours for those who are not imaged to assess for changes in clinical status.
  • Reassurance, Education, and Strict Return Precautions for those discharged without imaging.
  • Follow-up with primary care provider or neurologist and Return to Play/School anticipatory guidance if concussion is suspected.

Management

PECARN Algorithm: