cliot (version 1.0.0)

pediatric_nexus_ii_head_ct: Pediatric NEXUS II Head CT Decision Instrument

Description

Calculates the Pediatric NEXUS II result to determine the necessity of a head CT scan in children with blunt head trauma. The rule identifies patients at low risk for clinically important intracranial injury who may be safely managed without imaging. If any of the seven criteria are present, imaging is generally indicated.

Usage

pediatric_nexus_ii_head_ct(skull_fracture_evidence, scalp_hematoma,
                           neurologic_deficit, altered_alertness,
                           abnormal_behavior, coagulopathy, persistent_vomiting)

Value

A list containing:

Result

Recommendation regarding the need for Head CT ("Indicated" or "Not Indicated").

Inputs

A summary of the criteria evaluated.

Arguments

skull_fracture_evidence

Numeric (0 or 1). Evidence of significant skull fracture (e.g., palpable depression, basilar signs). (1 = Yes).

scalp_hematoma

Numeric (0 or 1). Presence of scalp hematoma. (1 = Yes).

neurologic_deficit

Numeric (0 or 1). Presence of neurologic deficit. (1 = Yes).

altered_alertness

Numeric (0 or 1). Altered level of alertness (GCS < 15). (1 = Yes).

abnormal_behavior

Numeric (0 or 1). Abnormal behavior present (e.g., agitation, somnolence, refusal to eat). (1 = Yes).

coagulopathy

Numeric (0 or 1). Presence of coagulopathy (history of bleeding disorder or anticoagulation). (1 = Yes).

persistent_vomiting

Numeric (0 or 1). Persistent vomiting. (1 = Yes).

References

Mower WR, Hoffman JR, Herbert M, et al. Developing a decision instrument to guide computed tomographic imaging of blunt head injury patients. J Trauma. 2005;59(4):954-959.

Examples

# Example 1: Low Risk
# No findings
pediatric_nexus_ii_head_ct(0, 0, 0, 0, 0, 0, 0)

# Example 2: CT Indicated (Hematoma)
# Scalp hematoma present
pediatric_nexus_ii_head_ct(0, 1, 0, 0, 0, 0, 0)