Risk Assessment
15-month-old fell from couch, alert, no findings
Why This Health Metric Matters
Why: This calculation helps assess important health parameters for clinical and personal wellness tracking.
How: Enter your values above and the calculator will apply validated formulas to compute your results.
- ●Evidence-based calculations
- ●Used in clinical settings worldwide
- ●Regular monitoring recommended
Clinical Scenarios
✅ Low Risk Infant
15-month-old fell from couch, alert, no findings
⚠️ Intermediate Risk Infant
18-month-old with occipital scalp hematoma after fall
🔴 High Risk Infant - AMS
8-month-old with altered mental status after fall
✅ Low Risk Child
7-year-old hit head playing, no symptoms
⚠️ Intermediate Risk Child
5-year-old with vomiting after fall
🔴 High Risk Child - LOC
10-year-old bike accident with LOC and vomiting
🚨 Basilar Skull Fracture Signs
6-year-old with hemotympanum after fall
Patient Information
Age Group: <2 years(automatically determined by age entered)
PECARN Criteria (<2 Years)
Additional Clinical Findings
Risk Assessment Results
Risk Category
ciTBI Risk
CT Recommendation
Observation
Risk Factor Distribution
ciTBI Risk Comparison
Clinical Recommendations
CT not recommended based on PECARN criteria
Safe for discharge with head injury precautions
Provide written return precautions to caregivers
Return Precautions (Head Injury Warning Signs)
Persistent or worsening headache
Repeated vomiting (more than 2-3 times)
Increasing confusion or drowsiness
Difficulty walking or loss of coordination
Slurred speech or difficulty speaking
Seizures or convulsions
Unequal pupils or vision changes
Clear fluid draining from nose or ears
Weakness or numbness in arms or legs
Behavior changes or unusual irritability
Discharge Instructions
Wake child every 2-4 hours for the first 24 hours to check responsiveness
Apply ice pack to areas of swelling for 15-20 minutes at a time
Give acetaminophen for headache (avoid ibuprofen/aspirin for first 24 hours)
Encourage rest and limit screen time for 24-48 hours
No contact sports or vigorous physical activity for 24-48 hours minimum
Ensure adult supervision for at least 24 hours
Return immediately if any warning signs develop
Clinical Pearls
PECARN has >99% sensitivity for ciTBI in this population
Patient can be safely discharged with appropriate precautions
Documentation Points
- •No PECARN predictors identified - Very Low Risk
- •CT not indicated per PECARN guidelines
- •Written and verbal head injury precautions provided
Risk Assessment
ciTBI Risk: <0.02% | CT not recommended
⚠️For informational purposes only — not medical advice. Consult a healthcare professional before acting on results.
🏥 Health Facts
— WHO
— CDC
What is the PECARN Head Injury Algorithm?
The PECARN (Pediatric Emergency Care Applied Research Network) head injury algorithm is the largest prospective pediatric head injury study ever conducted, involving over 42,000 children across 25 emergency departments. It provides evidence-based clinical decision rules to identify children at very low risk for clinically-important traumatic brain injury (ciTBI) who do not require CT imaging, thereby reducing unnecessary radiation exposure while maintaining patient safety.
High Risk (4.4%)
<2 years: Altered mental status OR palpable skull fracture
≥2 years: GCS <15 OR signs of basilar skull fracture
CT RECOMMENDED
Intermediate Risk (0.9%)
<2 years: LOC ≥5s, severe mechanism, not acting normally, non-frontal scalp hematoma
≥2 years: LOC, vomiting, severe headache, severe mechanism
CT vs OBSERVATION
Very Low Risk (<0.02%)
No PECARN predictors present. Extremely low risk for ciTBI.
CT NOT RECOMMENDED
How Does the PECARN Algorithm Work?
Children <2 Years Old
High Risk Predictors:
- Altered mental status
- Palpable skull fracture
Intermediate Risk Predictors:
- Loss of consciousness ≥5 seconds
- Severe mechanism of injury
- Not acting normally per parent
- Non-frontal scalp hematoma
Children ≥2 Years Old
High Risk Predictors:
- GCS <15
- Signs of basilar skull fracture
Intermediate Risk Predictors:
- Any loss of consciousness
- History of vomiting
- Severe headache
- Severe mechanism of injury
When to Use PECARN
✓ Appropriate Use
- • Children <18 years with blunt head trauma
- • GCS 14-15 on initial evaluation
- • Within 24 hours of injury
- • Minor head injury (not severe polytrauma)
✗ Not Appropriate
- • Penetrating head trauma
- • Known brain tumor or VP shunt
- • Bleeding disorders / anticoagulation
- • Pre-existing neurological disorder affecting exam
- • Presentation >24 hours after injury
Severe Mechanism of Injury Definitions
<2 Years (Fall >3 feet / 0.9m)
- • Motor vehicle crash with patient ejection
- • Death of another passenger
- • Rollover
- • Pedestrian or bicyclist without helmet struck by motorized vehicle
- • Falls >3 feet (>0.9 meters)
- • Head struck by high-impact object
≥2 Years (Fall >5 feet / 1.5m)
- • Motor vehicle crash with patient ejection
- • Death of another passenger
- • Rollover
- • Pedestrian or bicyclist without helmet struck by motorized vehicle
- • Falls >5 feet (>1.5 meters)
- • Head struck by high-impact object
Signs of Basilar Skull Fracture
Hemotympanum (blood behind eardrum)
Battle's sign (postauricular ecchymosis)
Periorbital ecchymosis (raccoon eyes)
CSF otorrhea (fluid from ear)
CSF rhinorrhea (fluid from nose)
PECARN Study Evidence
42,412
Children Studied
>99%
Sensitivity for ciTBI
25
Emergency Departments
100%
NPV in Very Low Risk