The PECARN Calculator is a critical clinical decision rule used by healthcare professionals to evaluate the risk of clinically important traumatic brain injury (ciTBI) in pediatric patients following head trauma. This essential clinical decision rule guides imaging decisions for children under and over two years old, aiding in crucial emergency care.
Formula:
The PECARN (Pediatric Emergency Care Applied Research Network) rule is not a direct mathematical formula but a comprehensive clinical decision algorithm. It meticulously stratifies children into very low-risk categories for ciTBI, making CT imaging potentially avoidable in appropriate cases.
Key Criteria for Assessment:
- For children < 2 years of age:
- Altered mental status (e.g., GCS < 15, irritability, somnolence, agitation)
- Palpable skull fracture
- Non-frontal, non-parietal, or non-temporal scalp hematoma
- History of loss of consciousness (LOC) > 5 seconds
- Severe mechanism of injury (e.g., fall > 3 feet, auto vs. pedestrian, high-impact object)
- Any vomiting (especially recurrent episodes)
- Irritable or abnormal behavior (not typical for the child)
- For children ≥ 2 years of age:
- Altered mental status (e.g., GCS < 15, disorientation, somnolence)
- Signs of basilar skull fracture
- History of loss of consciousness (LOC) > 5 minutes
- Any vomiting (especially recurrent episodes)
- Severe mechanism of injury (e.g., fall > 5 feet, auto vs. pedestrian, significant impact)
- Severe headache
This calculator aggregates these vital factors to suggest a low or higher risk of ciTBI, critically informing clinical judgment and imaging decisions.