• About
  • Masthead
  • License Content
  • Advertise
  • Submit Press Release
  • RSS/Email List
  • Write for us
  • Contact us
2 Minute Medicine
No Result
View All Result

No products in the cart.

SUBSCRIBE
  • Specialties
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • Wellness
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • AccountLog-in/out
    • Subscribe
    • Sign-in
    • My account
2 Minute Medicine
  • Specialties
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • Wellness
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • AccountLog-in/out
    • Subscribe
    • Sign-in
    • My account
SUBSCRIBE
2 Minute Medicine
Subscribe
Home The Classics Emergency Classics

The Canadian CT Head Rule [Classics Series]

bys25qthea
June 4, 2013
in Emergency Classics, The Classics
Reading Time: 3 mins read
0
Share on FacebookShare on Twitter

Image: CC/L. academia

1. The Canadian CT Head Rule consists of 7 predictor variables to assess the need for CT imaging in patients with minor head injuries.

2. This study demonstrates that the rule is highly sensitive and may help to reduce the number of CT scans ordered.

Study Rundown: The Canadian CT Head Rule was developed in this prospective cohort study. It is a highly sensitive clinical decision rule for patients with minor head injuries and has helped standardize the management of these patients. Moreover, these findings suggest that the Rule can help to reduce the number of CT scans ordered in assessing patients with minor head injuries.

In sum, the Canadian CT Head Rule is a clinical decision rule to standardize the management of patients presenting to the emergency department with minor head injury.

Please click to read study in The Lancet

In Depth [prospective cohort study]: First published in The Lancet in 2001, the Canadian CT Head Rule was designed to identify patients who required computed tomography (CT) after suffering minor head injuries. The definition of a minor head injury is a history of loss of consciousness, amnesia, or disorientation and a Glasgow Coma Scale (GCS) score of 13-15. At the time, there were conflicting guidelines regarding the use of CT in patients suffering these injuries, and the Canadian CT Head Rule sought to standardize the management of patients while reducing the number of unnecessary CT scans. This prospective cohort study was carried out in 10 Canadian community and academic centres. The primary outcome was the need for neurological intervention (i.e., death within 7 days due to head injury, or need for craniotomy, elevation of skull fracture, intracranial pressure monitoring, or intubation for head injury within 7 days), while the secondary outcome was the presence of clinically important brain injury identified on CT.

RELATED REPORTS

Low dose CT screening may detect early lung cancers: the NELSON trial

The NLST trial: Screening for lung cancer [Classics Series]

Physical examination sufficient to evaluate abdominal stab wounds

Patients requiring a CT were identified by standardized physician assessments, which included assessing for pre-determined predictor variables. Patients not requiring a CT were followed-up with a phone call 14 days after their assessment. A total of 3,121 patients were enrolled, and 2,078 of these patients received CT scans. Logistic regression was carried out to develop a model for identifying cases with clinically important brain injury, and the model was used to generate the 7 predictors in the Canadian CT Head Rule.

Canadian CT Head Rule
CT head is only required for minor head injury patients with any of these findings:
High risk (for neurological intervention)
  1. GCS score <15 at 2 hours after injury
  2. Suspected open or depressed skull fracture
  3. Any sign of basal skull fracture (i.e., hemotympanum, “racoon” eyes, CSF otorrhea/rinorrhea, Battle’s sign)
  4. Vomiting ≥2 episodes
  5. Age ≥65 years
Medium risk (for brain injury on CT)
  1. Amnesia before impact ≥30 minutes
  2. Dangerous mechanism (i.e., pedestrian struck by motor vehicle, occupant ejected from motor vehicle, fall from elevation ≥3 feet/5 stairs)

Subsequent analyses demonstrated that the 5 high risk factors had a sensitivity of 100% (95% CI 92-100%) and specificity of 68.7% (95% CI 67-70%) for neurological intervention, while CT scans would have been ordered in 32.2% of patients. When all 7 factors were considered, the sensitivity was 98.4% (95% CI 96-99%) and specificity was 49.6% (95% CI 48-51%) for clinically important brain injury on CT, while CT scans would have been ordered in 54.3% of patients.

By Adrienne Cheung, Andrew Cheung, M.D.

© 2013 2minutemedicine.com. All rights reserved. No works may be reproduced without written consent from 2minutemedicine.com. Disclaimer: We present factual information directly from peer reviewed medical journals. No post should be construed as medical advice and is not intended as such by the authors or by 2minutemedicine.com. PLEASE SEE A HEALTHCARE PROVIDER IN YOUR AREA IF YOU SEEK MEDICAL ADVICE OF ANY SORT. Content is produced in accordance with fair use copyrights solely and strictly for the purpose of teaching, news and criticism. No benefit, monetary or otherwise, is realized by any participants or the owner of this domain.

Tags: cthead injury
Previous Post

Television watching linked with antisocial behavior in children, supporting AAP recommendations

Next Post

More U.S. women using emergency contraception pill

RelatedReports

Many lung cancers visible on prior imaging studies
Imaging and Intervention

Low dose CT screening may detect early lung cancers: the NELSON trial

October 3, 2014
General Medicine Classics

The NLST trial: Screening for lung cancer [Classics Series]

November 26, 2013
Hypercortisolemia in ICU patients is due to reduced cortisol metabolism, not increased production
Surgery

Physical examination sufficient to evaluate abdominal stab wounds

July 13, 2013
Half of parents aware of CT radiation cancer risk
Imaging and Intervention

Half of parents aware of CT radiation cancer risk

September 14, 2013
Next Post

More U.S. women using emergency contraception pill

Fluid replacement with hydroxyethyl starch linked with higher mortality

Robotic-assisted hysterectomy lacks cost-benefit

License Our Award-Winning Physician-Written Medical News and Visual Abstracts

2 Minute Medicine is the leading authoritative medical news licensing service, and the only with reports written by practicing doctors.

LICENSE CONTENT

2MM+ Premium Access

No ads & unlimited access to all current reports, over 9000 searchable archived reports, visual abstracts, Weekly Rewinds, and the online edition of The Classics Series™ textbook.

Subscription Options
2 Minute Medicine

2 Minute Medicine® is an award winning, physician-run, expert medical media company. Our content is curated, written and edited by practicing health professionals who have clinical and scientific expertise in their field of reporting. Our editorial management team is comprised of highly-trained MD physicians. Join numerous brands, companies, and hospitals who trust our licensed content.

Recent Reports

  • Vitamin and mineral supplementation associated with minimal to no benefit in the primary preventing of cardiovascular disease and cancer – US Preventative Services Task Force
  • RSVpreF vaccine prevents symptomatic respiratory syncytial virus infection
  • Incidence of Kawasaki disease found to be lower during the COVID-19 pandemic in the United States
License Content
Terms of Use | Disclaimer
Cookie Policy
Privacy Statement (EU)
Disclaimer

© 2021 2 Minute Medicine, Inc. - Physician-written medical news.

  • Specialties
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • Wellness
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • Account
    • Subscribe
    • Sign-in
    • My account

© 2021 2 Minute Medicine, Inc. - Physician-written medical news.