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Indications for Non-Contrast CT Scan of Head

If none of these condition are met, consider not ordering CT scan of the head:

  1. GCS <13 when assessed (irrespective of time post injury)
  2. GCS <15 two hours post injury (discuss with surgeon)
  3. Any deterioration in condition
  4. Suspected open or depressed skull fracture
  5. Any sign of basal skull fracture
  6. Post traumatic seizure
  7. Focal neurological deficit
  8. >1 episode of vomiting
  9. Amnesia >30 minutes for events prior to injury
  10. LOC or amnesia and any of:
  • Age >65
    • Coagulopathy (bleeding/clotting disorder of anticoagulation, e.g. warfarin)
    • High risk mechanism, e.g. pedestrian vs. motor vehicle/ejected from vehicle/fall >1m
  • Additional considerations in children
    • Early vomiting is more common but ≥3 episodes should be considered significant
    • Tense fontanelle
    • Bruising, swelling, laceration >5 cm if <1 year old
      • NAI
      • Abnormal drowsiness
      • Anaesthetic and radiation relative risk/benefit. Consult with specialist
Altered conscious level should be attributed to head injury until proven otherwise. The decision to CT should be applied regardless of the influence of intoxication.
SOURCE: Indications for Non-Contrast CT Scan of Head ( )
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