Head Injury Rules
Canadian Head CT Rule:
Well validated, for adults
Apply ONLY to LOC, amnesia or confusion
https://www.mdcalc.com/calc/608/canadian-ct-head-injury-trauma-rule
New Orleans Head Trauma Rule:
May not apply in all settings
Apply ONLY to LOC, excludes confusion and amnesia to the trauma (only anterograde amnesia)
https://www.mdcalc.com/calc/604/new-orleans-charity-head-trauma-injury-rule#use-cases
Spine Injury Rules
Canadian C-Spine:
Sequential rule, can fail at any stage, high to low risk pts.
CAN be used in EtOH if alert/cooperative
https://www.mdcalc.com/calc/696/canadian-c-spine-rule
NEXUS C-spine Criteria:
Performs similarly to Canadian but has NO age criteria. Caution recommended in extremes of age due to high risk of this feature.
https://www.mdcalc.com/calc/703/nexus-criteria-c-spine-imaging
These clinical decision tools have been shown to decrease Xray utilization without missing clinically significant fractures. They are elegant tools for a more civilized age. Today’s practice environment generally eschews Xray for CT if imaging is required. Thyroid cancer would like a word.
Pediatric Head Injury Rules
PECARN Head Injury Algorithm:
Largest validated study
Age <2 vs. Age > 2 rules
100% sensitivity in Age < 2 group!
https://www.mdcalc.com/calc/589/pecarn-pediatric-head-injury-trauma-algorithm
NEXUS II Ped Head Trauma:
Age < 18, trauma within 24 hrs.
Only 35% males with avg age higher (12)
Excluded those without CT imaging
