Canadian ct head rules. Retrieved June 14, 2017, .

Canadian ct head rules “The Canadian CT Head Rule for patients with minor head injury. 2005;294(12):1511-1518. 32 On the basis of our findings of large reductions in the use of ankle radiography after the implementation of our Ottawa Ankle Rules, 11, 12 we estimate that a 25–50% relative reduction in CT head use could be safely Our survey of Canadian emergency physicians clearly indicates their willingness to adopt a decision rule for CT in patients with minor head injury. However, uncertainty about the clinical performance of these rules exists. BMJ. GCS score < 15 at 2 hrs after injury The web page reviews two clinical decision rules for selective use of CT in minor head injury: the New Orleans Criteria and the Canadian CT Head Rule. 1 Besides the Canadian Head CT Rule, which other clinical decision rules in adults are available to emergency physicians? Canadian CT Head Rule. It was originally described by Stiell et al. Dangerous mechanism ** (pedestrian, occupant ejected, fall from elevation) Stiell IG, et al. Emerg Med J. Crossref. JAMA 2005 Clinical Question: Compare the clinical performance of the Canadian CT Head Rule (CCHR) and New Orleans Criteria (NOC) decision rules for detecting the need for neurosurgical intervention and clinically important brain injury. “The Canadian C-spine rule versus the NEXUS low-risk criteria in patients with trauma. External validation of computed tomography decision rules for minor head injury: Prospective, multicentre cohort study in the Netherlands. Click all that apply: GCS 15 at 2 hours Suspected open or depressed skull fracture Signs of basal skull fracture Canadian CT head rules 423. A clinical decision rule to determine the need for CT head in adult patients with minor head injuries. (n. et al. It has 5 high-risk and 2 medium-risk factors based on Fortunately, the Canadian CT Head Rules (CCHR) helps to provide further clarification on who requires neuroimaging in patients with minor head injury 1. 4% (95% CI) High Risk (Need for urgent neurological intervention) Sensitivity 100% (95% CI) This infographic was created by Andrew Tolmie and edited by Alvin Chin REFERENCES: Stiell IG, Wells GA, Vandemheen K, Lesiuk H, Laupacis A et al. Before this the Royal College of Surgeons "Galasko" report guidelines had been followed. 9266 (2001): 1391-1396. >100 km/hr or ~60 mph, rollover, ejection) motorized recreational vehicles; Introduction: The Canadian Computed Tomography Head Rules (CCTHR) is a validated and well-known head injury clinical decision rule that allows Emergency Room Physicians (ERPs) to determine which patients are most likely to benefit from a diagnostic CT. Epub 2010 Aug 23. Guest Skeptics: Dr. However, this clinical decision rule is not uniformly adhered to and a number of preventable CT scans are ordered. Full Text. Setting Three university and six non-university hospitals in the The Canadian CT Head rules are used for patients with minor head injury. Canadian CT Head Rule CT head is only required for minor head injury patients with any one of these findings: High Risk (for Neurological Intervention) 1. Stiell et al. Stiell is the Principal Investigator for 1 of 3 Canadian sites in the Resuscitation Outcomes Consortium (ROC) which is funded by CIHR, NIH, HSFC, AHA, and While increasing CT use has considerably improved diagnostic capabilities and reduced hospital admissions, 9 it has also raised concern over unnecessary exposure to ionizing radiation. Full text After clinical assessment, a standard CT scan of the head was performed in patients having at least one of the risk factors stated in one of the two clinical decision rules. Stiell, Ian G et al. RANZCR drives optimum health outcomes by leading, training and sustaining our professionals in radiation oncology and clinical radiology. Results: We enrolled 1,582 patients. It is unclear if the typical factors associated with intracranial injury in published clinical decision rules for computerized tomography (CT) acquisition are helpful in differentiating patients with and without intracranial injuries, as intoxication may Commonly accepted clinical decision rules for detecting life-threatening complications in patients with mild head injury are New Orleans Criteria (NOC) and the Canadian CT Head Rules (CCHR) [3,4,12]. 2001 May 5;357(9266):1391‐6. ” New England Journal of Medicine 349. 2. CMAJ. A recent intervention trial failed to demonstrate a decrease in the rate of head CTs following implementation of the rule in Canadian emergency Canadian CT Head Rule: Availability. ). Blood thinners. axial load to the head; high-speed motor vehicle collision (e. Ann Emerg Med 2001; 38(2): 160–169. Date reviewed: May 2018 Date of next review: May 2021 Published: June 2018 Quick User Guide Move the mouse cursor over the PINK text boxes inside the flow chart to bring up a pop up box with salient Much of the time, these are negative, or find injuries for which no intervention is ever done and do not clinically affect the patient. SGEM #106: O Canada – Canadian CT Head Rule for Patients with Minor Head Injury. Application of the Canadian CT Head Rules in managing minor head injuries in a UK emergency department: implications for the implementation of the NICE guidelines. The Canadian CT Head Rule for Patients with Minor Head Injury. 11 – 13 The Canadian CT Head Rule comprises five high-risk and two medium-risk criteria and was derived by prospectively evaluating 3121 adults with The Canadian Head CT Rule (Canadian), New Orleans Criteria (New Orleans), NEXUS II Head CT Rule (NEXUS), and PECARN Pediatric Head Injury Algorithm (PECARN) are four major decision rules designed to assist clinicians with this often difficult decision. 091974. Stiell is the Principal Investigator for 1 of 3 Canadian sites in the Resuscitation Outcomes Consortium (ROC) which is funded by CIHR, NIH, HSFC, AHA, and This pathway provides guidance on imaging adults with a recent head injury. 32 On the basis of our findings of large reductions in the use of ankle radiography after the implementation of our Ottawa Ankle Rules, 11,12 we estimate that a 25–50% relative reduction in CT head use could be safely He is best known for the development of the Ottawa Ankle Rule, the Canadian C-Spine Rule, and Canadian CT Head Rule and as the Principal Investigator for the landmark OPALS Studies for prehospital care. Article 3: Clinical Prediction or Decision Rule Comparison of the Canadian CT Head Rule and Canadian C-spine rules are a set of guidelines that help a clinician decide if cervical spine imaging is not appropriate for a trauma patient in the emergency department. None were performed for the purposes of risk. The Canadian rules were designed to identify a set of objective criteria for determining whether trauma patients As a resident at the University of Pittsburgh, I was convinced that CT was overused in patients with minor head injury (MHI). This would suggest that while clinicians report that The Canadian CT head rule is a effective method for determining the need for a patient to receive a non contrast brain CT after head trauma. 1519‐1525 S ell, IG et al. "Minor" head injury (sometimes known as "mild") is defined by a history of loss of consciousness, amnesia, or disorientation in a patient who is cons Ian Stiell and colleagues (May 5, p 1391), 1 in their study of use of computed tomography in patients with minor head injury, made every effort to follow up all the patients with head trauma to a clinical conclusion. CT of the head is required for children with minor head injury* and any 1 of . Article 1: Indications for Computed Tomography in Patients with Minor Head Injury, NEJM 2000; 343: 100-105 ANSWER KEY. Sarah Berg is a PGY-3 resident in To standardise and increase the efficiency of CT usage, independent clinical decision rules, such as the Canadian Computed Tomography Head Rule (CCHR), have been developed. 357(9266):1391 Many experts rely on clinical gestalt to identify patients at high risk who should undergo head CT imaging for trauma. PubMed "Canadian computed tomography head rule" [Title / Abstract] OR "Canadian CT head rule" [Title / Abstract] OR "New Orleans criteria" [Title / Abstract] In addition to the systematic search, a manual search was also performed via Google and Google scholar search engines and in related articles’ bibliography to include articles that were not indexed or not found. This study evaluates the effects of the protocol and discusses the impact of the implementation of the NICE head injury guidelines-also based on the Canadian CT rules. Scandinavian guidelines for initial management of minimal, mild, and moderate head injuries: the Scandinavian Neurotrauma Interpretation We have developed the Canadian CT Head Rule, a highly sensitive decision rule for use of CT. 2004;21(4):426-428. Background The Canadian CT Head Rule was prospectively derived and validated to assist clinicians with diagnostic decision-making regarding the use of computed tomography (CT) in adult patients with minor head injury. Retrieved June 14, 2017, The Canadian CT head rule (CCTHR) is a validated clinical decision rule to determine the need for CT head in adult emergency department patients with minor head injuries. 2005 Sep 28;294(12):1511-8 The Canadian CT Head Rule Study for patients with minor head injury: rationale, objectives, and methodology for phase I (derivation). This study aimed to evaluate the effect of the Canadian CT head rule supplemented by the original published minimum inclusion criteria to assist clinician assessment of the need for CTB following minimal Smits M et al. Full Text (PDF) Scopus (1176) PubMed. Date: September 10th, 2019 Reference: Fournier et al. Articles. g. Objectives: Studies focusing on minor head injury in intoxicated patients report disparate prevalences of intracranial injury. Before this the Royal College of Surgeons "Galasko" report guidelines had been followed. 1391‐1396 Last updated: 7/30/2020 We evaluate the efficacy of the Canadian CT head rule (CCHR) on head CT imaging in minor head injury (MHI) and its association Lingsma HF, van der Naalt J, Jacobs B, Eline de Jong, et al. doi: 10. 2001; 357:1391-1396. 6% vs 12. We compare the performance of both decision rules for identifying patients with intracranial traumatic lesions and those who require an urgent neurosurgical intervention after mild head injury. Use clinical decision rules to determine need. 6% specific, respectively, for these injuries. The management of the MHI patients was compared (table 1B). Medium Risk (for Brain Injury on CT) 6. Studies of the New Orleans Criteria, Canadian CT Head Rule, and National Emergency X-Radiography Utilization Study (NEXUS) have included intoxicated patients as part of their derivation cohorts, suggesting the rules can be applied to patients with intoxication (Appendix 1). PMID: 16189365. Lancet. 32 On the basis of our findings of large reductions in the use of ankle radiography after the implementation of our Ottawa Ankle Rules, 11,12 we estimate that a 25–50% relative reduction in CT head use could be safely Sultan HY, Boyle A, Pereira M, Antoun N, Maimaris C. Log in Sign up. ” The Lancet 357. 2001. Nathan Kuppermann's publications, visit PubMed. Objective To externally validate four commonly used rules in computed tomography (CT) for minor head injury. This study evaluates the effects of the protocol and discusses The Canadian CT head rule (CCTHR) is a validated clinical decision rule to determine the need for CT head in adult emergency department patients with minor head injuries. Patient has suffered minor head trauma We have developed the Canadian CT Head Rule, a highly sensitive decision rule for use of CT. Patients with positive traumatic head injury according to BT results defined as Group 1 and those who had no intracranial injury defined as Group 2. This would actually lead to an increase in the use of CT in most Canadian and European sites. 26 (2003): 2510-2518. com. External validation of the Canadian CT Head Rule and the New Orleans Criteria for CT scanning in patients with minor head injury. A prospective cohort study derived a clinical decision rule for use of CT in patients with minor head injury based on five high-risk and two medium-risk factors. The CCHR has been externally validated and was found to be highly sensitive for detecting intracranial injuries, but with variation in its specificity. 10–14 Although the calculation of projected cancer risk is still controversial, some studies suggest that CT scans of the head may be among the largest contributors to radiation exposure due to the ©RANZCR® 2015 Adult Head Trauma 1 | P a g e Canadian CT Head Rule Summary Statement: The Canadian CT Head Rule (CCHR) is a widely validated CDR for use in the emergency department for patients with minor head injury to identify clinically important brain injuries on CT scan that may require neurosurgical intervention. • Smits M, Dippel DW, de Haan GG, et al. Stiell is the Principal Investigator for 1 of 3 Canadian sites in the Resuscitation Outcomes Consortium (ROC) which is funded by CIHR, NIH, HSFC, AHA, and Objective:: In 2002 a new protocol was introduced based on the Canadian CT rules. Inclusion criteria. 14. 2018 Our survey of Canadian emergency physicians clearly indicates their willingness to adopt a decision rule for CT in patients with minor head injury. Since then, the CCTHR has become the mo The Canadian Head CT Rules apply only to patients with a GCS score of 13-15 who have experienced a head injury with loss of consciousness, amnesia, or altered mental status. A second clinical decision rule, the Canadian CT Head Rule, was developed using 3,121 patients 16 to 99 years of age who presented with minor head injury (defined as GCS score of 13 to 15 after on CT) Sensitivity 98. Stiell IG, Clement CM, Rowe BH, Schull MJ, BrisonR, Cass D, Eisenhauer MA et al. 7%) and thus could result in fewer CT Scans. In head-to-head evaluations, the Canadian CT Head Rule out-performed other clinical decision rules, particularly the New Orleans Criteria, with equal sensitivity, but improved Smits, S et al. External Valida on of the Canadian CT Head Rule and the New Orleans Criteria for CT Scanning in Pa ents with Minor Head Injury. Lancet, 357, 1391 Some physicians in this study reported incorporating steps from other head rules into the Canadian CT Head Rule. The Canadian CT Head Rule for Pa ents with Minor Head Injury. Adapting the Canadian CT head rule age criteria for mild traumatic brain injury. study period. He is best known for the development of the Ottawa Ankle Rule, the Canadian C-Spine Rule, and Canadian CT Head Rule and as the Principal Investigator for the landmark OPALS Studies for prehospital care. Application of the Canadian CT head rules in managing minor head injuries in a UK emergency department: implications for the implementation of the NICE guidelines. References. d. Lancet 2001;357:1391-96. JAMA. (Stiell 2010) The point of the decision rule is to decrease CT usage. Studies evaluating the performance of the CCHR The Canadian CT Head Rule (CCHR), New Orleans Criteria (NOC), and National Emergency X-Ray Utilization Study (NEXUS)-II criteria are amongst the rules which are used widely 5, 12, 13 . Content Contributors Of note, the Canadian CT Head Rules were designed to be used in GCS 13-15 patients with witnessed loss of consciousness, amnesia to the head injury event, or confusion. 2005;294(12):1519-1525. Download the new PECARN Pediatric Head CT Rule cards by clicking the buttons below! A big shout out to Gabe Sudario who came up with this initiative and gathered an international team to collaborate on this project. Amnesia before impact ≥ 30 min 7. He has been the lead or senior investigator on several research studies developing and validating clinical prediction rules. 2001 May 5;357(9266):1391-6, abgerufen am 05. Exclusion criteria: Age <16 years. The Canadian CT Head Rule for patients with minor head injury, Lancet. Emergency Medicine Journal 2019. Google Scholar. The Canadian C-Spine (cervical-spine) Rule (CCR) and the National Emergency X-Radiography Utilization Study (NEXUS) Low-Risk Criteria (NLC) are decision rules to guide the use of cervical-spine rad. New Orleans Criteria and Canadian CT Head Rule decision rules were compared by using sensitivity specifications and positive and negative predictive value. Canadian Traumatic Brain Injury Research Consortium. This rule Clinical decision (or prediction) rules attempt to reduce the uncertainty of medical decision-making by standardising collection and interpretation of clinical data. Head CT in Trauma (Clinical Decision Rules) CME. 2001;357(9266):1391-1396. 2001 The US yield of CT for intracranial lesions in minor head injury is estimated to be quite low (0·7–3·7%). Comparison of the Canadian CT Head Rule and the New Orleans Criteria in patients with minor head injury , JAMA. If any criteria are met, CT Head is indicated. CT Head decision rules help clinicians decide when to order a CT. The Canadian CT Head Rule (CCHR) and New Orleans Criteria (NOC) are previously developed clinical decision rules to guide CT use for patients with minor head injury and with Glasgow Coma Scale (GCS) scores of 13 to 15 for The Canadian CT Head Rule (CCHR) and the New Orleans Criteria (NOC) are widely used screening tools to rule out clinically important brain injury without CT imaging. 1519- 1525. Clinical decision rules are derived from original research and may be defined as tools for clinical decision-making that incorporate three or more variables from a patient’s history, physical examination or simple tests. Although these tools are well validated in studies from upper- and middle-income countries, it is important to study these tools in low-income countries. Only apply to patients with Glasgow Coma Scale (GCS) 13-15 and at least one of the following: Loss of consciousness. Lancet 2001 May 5, 357 (9266): 1391-6. stratification after head injury. Before this the Royal College of Surgeons “Galasko” report guidelines had been followed. The Canadian CT Head Rule for patients with minor head injury. The PECARN Pediatric Head Injury/Trauma Algorithm provides the PECARN algorithm for evaluating pediatric head injury. www. CT head scan not needed Do a CT head scan within 1 hour of any of the risk factors being identified Make a provisional written radiology report available within 1 hour of the scan Yes Consider a CT head scan within 8 hours of injury, or within 1 hour if they present more than 8 hours after injury Make a provisional written radiology report The most well-known clinical decision rules include the New Orleans Criteria and the Canadian CT Head Rule, originally published in 2000 and 2001, respectively [9, 10]. Patients who did not have CT scans were followed up by telephone for 2 weeks to explore whether they had clinically important brain lesions. 9,10 These decision-making tools are derived Stiell IG, Wells GA, Vandemheen K, et al. PubMed; Stiell IG, Clement CM, Rowe BH, et al. Reference: Stiell et al. Stiell IG, Wells GA, Vandemheen K. 1503/cmaj. This study evaluates the effects of the protocol and discusses the impact of the implementation of the NICE head injury guidelines—also based on the Canadian CT rules. There is a considerable gap between our understanding of the rules of application and in the consistency of utilization of the CCHR by physicians [11-13,16]. in a paper published in the Lancet in 2001, in which they initially used it only on patients with Glasgow Coma Scale scores of between 13 and 15. The rule uses six risk factors and exclusion criteria to predict the need for neurological intervention. The Canadian CT Head Rule (CCHR) was prospectively derived on 3121 patients who had a minor head injury, defined as a GCS of 13 or greater with witnessed loss of consciousness, disorientation or definite amnesia 3, 20, 21; The authors found that patients with minor head injury could be classified into two levels of risk. 2001;357(9266), pp. The following chart is intended to help physicians and their patients make evidence-informed decisions regarding the use of MRI and CT in the assessment and diagnosis of common issues related to headache in adults. When assessing decision rules we often get hung up on sensitivity and specificity, A prospective cluster-randomized trial to implement the Canadian CT Head Rule in emergency departments. Amnesia to the head injury event. these findings: • GCS score < 15 at 2 hours after injury • Suspected open or depressed skull fracture • History of worsening headache • Irritability on examination • Any sign of basal skull fracture† • Large, boggy hematoma of the scalp • Dangerous Context: Two decision rules for indications of computed tomography (CT) in patients with minor head injury, the Canadian CT Head Rule (CCHR) and the New Orleans Criteria (NOC), suggest that CT scanning may be restricted to patients with certain risk factors, which would lead to important reductions in the use of CT scans. from publication External Validation of the Canadian CT Head Rule and the New Orleans Criteria for CT Scanning in Patients with Minor Head Injury. The 3 major adult CT Clinical decision rules are summarised at Academic Life in Emergency Medicine in a handy ‘Paucis Verbis’ card: Head CT Decision Rules in Trauma Our survey of Canadian emergency physicians clearly indicates their willingness to adopt a decision rule for CT in patients with minor head injury. Our research group is currently validating the Canadian CT head rule at 8 tertiary-care hospitals as part of the Canadian CT Head and C-Spine (CCC) Study to develop decision rules for CT head and cervical spine radiography. 8 More selective use of this expensive high technology investigation for patients with minor head injury could lead to large reductions It showed both had 100% sensitivities, but the Canadian CT Head Rule was more specific (50. 3, 6, 8 However, the performance of these rules in the intoxicated population Quick Reference Guide: Use of MRI and CT in Adult Patients Presenting with Headache . Full pdf. The Canadian CT Head Rule (CCHR) and New Orleans Criteria (NOC) are previously developed clinical decision rules to guide CT use for patients with minor head injury and with Glasgow Coma Scale Do not routinely image (including CT & MRI). The Canadian Head CT Rules apply only to patients with a GCS score of 13-15 who have experienced a head injury with loss of consciousness, amnesia, or altered mental status. PMID: 20732978. Rules out need for head CT in minor head trauma. More about the College It showed both had 100% sensitivities, but the Canadian CT Head Rule was more specific (50. Article 2: Clinical Prediction or Decision Rule The Canadian CT Head Rule for Patients with Minor Head Injury, Lancet 2001; 357: 1391-1396 ANSWER KEY. These two rules were externally validated in the previous studies but we believe that application of these decision rules may still be limited in populations with different demographic the Canadian CT head rule on British practice. A large number of CT brain (CTB) scans are ordered in the ED for older patients with a confirmed or possible head strike but no ongoing symptoms of a head injury. 2022 Stiell IG et al. Dr. 2005;294(12), pp. Both have been validated in thousands of patients as essentially 100% sensitive for mild head trauma requiring neurosurgical intervention [4, 11]. Comparison of the Canadian CT Head Rule and the New Orleans Criteria in patients with minor head injury. See Also Core EM Post on the New Orleans’ Head CT Criteria The Canadian CT-scan Head Rule (CCHR) has been found to be the most effective clinical decision rule in adults with minor head injuries. The rule was 100% sensitive Learn how to apply the Canadian CT Head Rule to determine when to order a CT scan for patients with minor head injury. 05. 6, 7 We have previously shown a four-fold variation among similar Canadian teaching hospitals in the use of CT for minor head injury. 1997; 278:2075-2078. not sure if this was made explicit, but the Canadian CT head rules excluded with “minimal head injuries” (ie no loss of consciousness, amnesia to the head injury event or witnessed disorientation) thus the decision to scan patients over 65 with minimal head injuries is not informed by this clinical decision making rule, only judgement alone. However, it is unclear to what extent clinicians He is best known for the development of the Ottawa Ankle Rule, the Canadian C-Spine Rule, and Canadian CT Head Rule and as the Principal Investigator for the landmark OPALS Studies for prehospital care. It considers loss of consciousness, GCS, confusion, amnesia, and risk Learn how to use the Canadian CT Head Rule to decide whether a head CT is needed for adult patients with minor head injury. The Lancet. emjonline. External validation of the Canadian CT head rule and the New Orleans criteria for CT scanning in patients with minor head injury. The Canadian CT head rule is one of the few decision rules to be tested in an RCT, and it looks like it might cause harm (and definitively does not help). Rule Not Applicable If: - Non-trauma cases - GCS < 13 - Age < 16 years - Coumadin or Study objective: The New Orleans Criteria and the Canadian CT Head Rule have been developed to decrease the number of normal computed tomography (CT) results in mild head injury. Implementation of the Ottawa Knee Rules for the use of radiography in acute knee injuries. Some also reported difficulty understanding and remembering all of the steps when using the rule. Notably, the vast majority of patients presenting to the ED do Download scientific diagram | Canadian CT head rule poster as published by Stiell et al 5 (reproduced with permission). Katzman, R ∙ Brown, T ∙ Fuld, P ∙ et al. Design Prospective, multicentre cohort study. When I became faculty at Charity Hospital in New Orleans, Clinical decision rules do not replace Topic Trauma – Minor Head Injury Adults Citation: Canadian CT Head Rule, Stiell et al. Head injuries are among the most common types of trauma seen in North American emergency departments, with an estimated 1 million cases seen annually. OPTION 1 : Adobe PDF: Available at no cost, download the PDF files to your local printer for professional printing and laminating, or print from home or the office. Examples of validated decision rules: • Canadian CT Head Rule • New Orleans/Charity Head Trauma/Injury Rule • NEXUS For patients on anticoagulation or antiplatelet therapy (except for aspirin): • Highly consider imaging. 2004;21(4):420–425. Objective: In 2002 a new protocol was introduced based on the Canadian CT rules. JAMA 2005; 294(12): 1519-25. Several validated decision rules are available for clinicians to guide the appropriate use of imaging for patients with musculoskeletal injuries, including the Canadian CT Head Rule, Canadian C-Spine Rule, National Emergency X-Radiography Utilization Study (NEXUS) guideline, Ottawa Ankle Rules and Ottawa Knee Rules. The Canadian CT Head Rules have been used to formulate the guideline. Current use of cranial computed tomography (CT) for minor head injury is increasing rapidly, highly variable, and inefficient. Witnessed disorientation. PubMed. Ingebrigtsen, T ∙ Romner, B ∙ Kock-Jensen, C. See the criteria, exclusions, and references The Canadian CT head rule (abbreviated CCTHR or CCHR; also sometimes referred to as the Canadian Computed Tomography Head Rule) is a medical scale used to decide whether patients with minor head injuries should undergo cranial CT scans. To view Dr. CSF, cerebrospinal fluid; GCS, Glasgow Coma Scale. The Canadian CT Head Rule (CCHR) and New Orleans Criteria (NOC) are previously developed clinical decision rules to guide CT use for patients with minor head injury and with Glasgow Coma Scale (GCS) scores of 13 to 15 for the CCHR and a Stiell, Ian G et al. Patient has suffered minor head trauma The Canadian CT Head Rule (CCHR) and New Orleans Criteria (NOC) are previously developed clinical decision rules to guide CT use for patients with minor head injury and with Glasgow Coma Scale (GCS) scores of 13 to 15 for the CCHR and a score of 15 for the NOC. 2010 Oct 5;182(14):1527-32. 50. Poster (29 KB PDF) Pocket Card (Coming soon!) OPTION 2 : "The Canadian CT Head Rule for patients with minor head trauma". [PMC free article] [Google Scholar] 17. Context. Prior rules, such as PECARN or CHALICE, applied only to specific subgroups of patients, while the inclusion and exclusion criteria of other rules, such as the Canadian Head CT Rule, preclude their application in over one-third of blunt Objective: : In 2002 a new protocol was introduced based on the Canadian CT rules. It compares their accuracy, sensitivity, The Canadian CT Head Rule (CCHR) is a CDR for minor head injury to identify brain injuries on CT scan that may need neurosurgery. zbsz wgwz wucbfx nrty rvukrdv popeaeo buyf jful yxio yvcbm