See Management of Severe Head Injury
See Management of Minor Head injury

If GCS < 8 then go immediately to Management of Severe Head Injury

  Mild Moderate Signficant
Loss of consciousness None < 2 min > 2 min
Amnesia None < 20 min > 20 min
Headache Mild Moderate Severe,Worsening
Vomiting < 1 episdoe > 1 episode  
Seizure No Brief Prolonged/Recurrent
Other findings None None Basal skull #
Penetrating injury
Depressed #
Focal findings (unequal pupils/limb weakness)
Other factors   Intoxicated Anticoagulated
Bleeding disorder
GCS 15 14-15 < 13
MANAGEMENT Discharge with head injury card* 1/24 neuro obs for 4/24

If sober and no deterioration then discharge with head injury card*
If deterioration then urgent CT

Urgent CT brain (within 60 min if  GCS < 8 )

Urgent neurosurgical consult

* all patients who are discharged with head injury card must be accompanied by responsible adult

Basal skull fracture - features


Criteria for CT Head Scan
Management of Severe Head Trauma
See also Head injury card under handouts