CHALICE (Children’s Head injury ALgorithm for the prediction of Important Clinical Events) Rule

CHALICE (Children's Head injury ALgorithm for the prediction of Important Clinical Events) Rule
This decision tool is intended to help determine whether a CT scan is needed to evaluate a child's head injury.
***History***
[select name="Q1" value="no=0|YES=1"] <-- Witnessed Loss of Consciousness > 5 minutes
[select name="Q2" value="no=0|YES=1"] <-- Amnesia > 5 minutes (retrograde or antegrade)
[select name="Q3" value="no=0|YES=1"] <-- Abnormal drowsiness (Abnormal ~ exceeds drowsiness expected by the examining doctor)
[select name="Q4" value="no=0|YES=1"] <-- 3 or more vomiting episodes after head injury
[select name="Q5" value="no=0|YES=1"] <-- Any suspicion of Non-Accidental Injury (NAI)
[select name="Q6" value="no=0|YES=1"] <-- Seizure after head injury (and no previous history of epilepsy)
***Examination***
[select name="Q7" value="no=0|YES=1"] <-- GCS <14 (or GCS <15 if <1 year old) [link url="//www.soapnote.org/neurological/gcs/" memo="Glasgow Coma Scale"]
[select name="Q8" value="no=0|YES=1"] <-- Suspicion of penetrating or depressed skull injury, or tense fontanelle
[select name="Q9" value="no=0|YES=1"] <-- Signs of basal skull fracture (Blood or CSF from ear or nose, panda eyes, Battle's sign, hemotympanum, facial crepitus, or serious facial injury)
[select name="Q10" value="no=0|YES=1"] <-- Positive focal neurologic sign (Any focal neurologic sign  - motor, sensory, coordination, or reflex abnormality)
[select name="Q11" value="no=0|YES=1"] <-- Bruise, swelling or laceration >5 cm (if <1 year old)
***Mechanism***
[select name="Q12" value="no=0|YES=1"] <-- High‐speed road traffic accident as pedestrian, cyclist or occupant (High-speed: >40 mph or 64 km/h)
[select name="Q13" value="no=0|YES=1"] <-- Fall of >3 meters in height
[select name="Q14" value="no=0|YES=1"] <-- High‐speed injury from a projectile or an object

Score --> [calc memo="result" value="score=(Q1)+(Q2)+(Q3)+(Q4)+(Q5)+(Q6)+(Q7)+(Q8)+(Q9)+(Q10)+(Q11)+(Q12)+(Q13)+(Q14)"]
Interpretation --> [calc memo="result" value="score2=(Q1)+(Q2)+(Q3)+(Q4)+(Q5)+(Q6)+(Q7)+(Q8)+(Q9)+(Q10)+(Q11)+(Q12)+(Q13)+(Q14);score2>0?'CT scan is recommended due to risk of intracranial pathology':'Low risk of intracranial pathology'"]
[checkbox memo="display/hide references" name="footnotes" value=""][conditional field="footnotes" condition="(footnotes).isNot('')"]
reference: [link url="https://www.ncbi.nlm.nih.gov/pubmed/17056862" memo="#1"] Dunning J, Daly JP, Lomas JP, Lecky F, Batchelor J, Mackway-Jones K; Children's head injury algorithm for the prediction of important clinical events study group. 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 Nov;91(11):885-91.[/conditional]