Minor head injury – PECARN — RACP Paediatrics MCQ

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EasyNeurologyMinor head injury – PECARNRACP Paediatrics

A 2-year-old falls from a 60 cm height and has a brief (<5 second) loss of consciousness. She now has a GCS of 15, no vomiting, a small frontal haematoma, and is behaving normally. Per the PECARN clinical decision rule, what is the most appropriate management?

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Correct answer: D — Observation with neurological observations

Per the PECARN rule for children <2 years, this child has a risk factor (LOC, not acting normally initially, scalp haematoma) but is now well. The risk of clinically important TBI is ~1%. CT is not routinely recommended. Observation for 4-6 hours with serial neurological observations is appropriate. CT should be performed if the child deteriorates.

Reference: RCH Melbourne – 2023 – Head Injury CPG; PECARN clinical decision rule