PECARN prediction rule for child younger than 2 years of age with minor blunt head trauma

Child is at very low risk of clinically-important traumatic brain injury if all the following are met: 

• GCS =15 and no other signs of abnormal mental status

• No history of loss of consciousness (LOC) or LOC<5 seconds 

• No severe mechanism of injury*

• No temporal, parietal, or occipital scalp hematoma

• Acting normally per parent

• No palpable or suspected skull fracture

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*Severe mechanism is defined as any of the following: fall of more than 3 feet; motor vehicle crash with patient ejection, death of another passenger, or rollover; pedestrian or bicyclist without helmet struck by a motorized vehicle; or head struck by a high impact object.

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Adapted with permission from Kuppermann, N. 2012, from Identification of children at very low risk of clinically-important brain injuries after head trauma: a prospective cohort study. Lancet 2009;374:1160-70.