TBI in the pediatric population is rare, occuring in 0.9% of the 42,412 PECARN population
The primary ED question is whether or not to perform a<unk>  CT to assess for intracranial hemorrhage
Cranial ultrasound is a poor screening tool for bleeding
The PECARN rule has become standard of care to determine which patients need CT imaging
In patients <2 yrs the aid is 100% sensitive with NPV of 100%
In patient >2 yrs the aid is 96.8% sensitive with NPV of 99.95% (with validation studies showing sensitivity of 100% for TBI and injury requiring neurosurgery
Cranial ultrasound is a poor screening tool for bleeding
In patients <2 yrs the aid is 100% sensitive with NPV of 100%
In patient >2 yrs the aid is 96.8% sensitive with NPV of 99.95% (with validation studies showing sensitivity of 100% for TBI and injury requiring neurosurgery
Note:
For Motor score 4, pain is defined flat, fingernail pressure (often performed with the barrel of a pencil).
For Motor scores 2 and 3, pain is defined by pressing hard on the supraorbital notch. If this unsuccessful, sternal pressure may also be attempted.
Head trauma 
Traumatic brain injury
Blast injury
Intracranial hemorrhage
Traumatic asphyxia
Moderate-to-severe traumatic brain injury
Trauma 
Elevated intracranial pressure