Emergency Medicine · Paediatrics
CHALICE Head Injury Rule (Positive Count) calculator
Enter the published formula inputs below to calculate and interpret this score.
Clinical inputs
Result
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0
0 criteria — low risk
Band: 0 criteria — low risk
Interpretation. 0 criteria — low risk
Suggested management. No CHALICE criterion is present: the rule classes the child as low risk of a clinically significant intracranial injury.
CHALICE Head Injury Rule (Positive Count): 0 — 0 criteria — low risk. Interpretation: 0 criteria — low risk What to do: No CHALICE criterion is present: the rule classes the child as low risk of a clinically significant intracranial injury. Inputs: Witnessed loss of consciousness >5 min: false; Amnesia (anterograde or retrograde) >5 min: false; Abnormal drowsiness (noted by the examining doctor): false; ≥3 vomits after the head injury: false; Suspicion of non-accidental injury: false; Seizure after the head injury, with no history of epilepsy: false; GCS <14, or <15 if under 1 year old: false; Suspected penetrating or depressed skull injury, or tense fontanelle: false; Signs of basal skull fracture: false; Positive focal neurological sign: false; Bruise, swelling or laceration >5 cm (if under 1 year old): false; High-speed road traffic accident (>40 mph / 64 km/h) as pedestrian, cyclist or occupant: false; Fall from more than 3 m: false; High-speed injury from a projectile or object: false Source: Dunning J et al. Derivation of the children's head injury algorithm for the prediction of important clinical events decision rule for head injury in children. Arch Dis Child 2006;91:885-891. DOI: 10.1136/adc.2005.083980. PMID: 17056862. A CT scan is required if any of 14 criteria is present. History: witnessed loss of consciousness >5 min; amnesia (anterograde or retrograde) >5 min; abnormal drowsiness; >=3 vomits after the head injury; suspicion of non-accidental injury; seizure after head injury in a child with no history of epilepsy. Examination: GCS <14, or <15 if under 1 year; suspicion of penetrating or depressed skull injury or tense fontanelle; signs of basal skull fracture; positive focal neurology; bruise, swelling or laceration >5 cm if under 1 year. Mechanism: high-speed road traffic accident (>40 mph) as pedestrian, cyclist or occupant; fall >3 m; high-speed injury from a projectile or object. If none is present the child is at low risk of intracranial pathology. (2006)
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Clinical inputs
- Witnessed loss of consciousness >5 min
- Amnesia (anterograde or retrograde) >5 min
- Abnormal drowsiness (noted by the examining doctor)
- ≥3 vomits after the head injury
- Suspicion of non-accidental injury
- Seizure after the head injury, with no history of epilepsy
- GCS <14, or <15 if under 1 year old
- Suspected penetrating or depressed skull injury, or tense fontanelle
- Signs of basal skull fracture
- Positive focal neurological sign
- Bruise, swelling or laceration >5 cm (if under 1 year old)
- High-speed road traffic accident (>40 mph / 64 km/h) as pedestrian, cyclist or occupant
- Fall from more than 3 m
- High-speed injury from a projectile or object
Primary source
Dunning J et al. Derivation of the children's head injury algorithm for the prediction of important clinical events decision rule for head injury in children. Arch Dis Child 2006;91:885-891. DOI: 10.1136/adc.2005.083980. PMID: 17056862. A CT scan is required if any of 14 criteria is present. History: witnessed loss of consciousness >5 min; amnesia (anterograde or retrograde) >5 min; abnormal drowsiness; >=3 vomits after the head injury; suspicion of non-accidental injury; seizure after head injury in a child with no history of epilepsy. Examination: GCS <14, or <15 if under 1 year; suspicion of penetrating or depressed skull injury or tense fontanelle; signs of basal skull fracture; positive focal neurology; bruise, swelling or laceration >5 cm if under 1 year. Mechanism: high-speed road traffic accident (>40 mph) as pedestrian, cyclist or occupant; fall >3 m; high-speed injury from a projectile or object. If none is present the child is at low risk of intracranial pathology. (2006)
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