🧒 CHALICE Pediatric Head Injury Rule
UseWhen to use: children presenting after head injury when a structured CT rule is appropriate.
StrataRule-positive → urgent CT pathway; rule-negative still needs advice and safeguarding.
LimitsWhen not to use: when local NICE or PECARN pathways are mandatory and… · Pitfall: underplaying non-accidental injury suspicion. · Age <1 year uses GCS <15 threshold.
SourceNICE head injury guidance (tool-page edition) on applicable locales
This-shift next steps
After scoring: open the scene pack, peer scores, and the matching pathway. Local reference — no HIS write.
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Methodology · worked example, guidelines & full notes
Any-one-positive rule.
When to use
When to use: children presenting after head injury when a structured CT rule is appropriate.
How it works
Any one positive history/exam/mechanism criterion → CT indicated; all negative → low risk.
Key points
- Any-one-positive rule.
- Includes mechanism criteria.
- Next: PECARN / NICE as locally preferred; neurosurgery if deteriorating.
References
- [Guideline / primary source]NICE head injury guidance (tool-page edition) on applicable locales
- Dunning J, et al. Arch Dis Child 2006 (CHALICE)
Worked calculation
The values below come from this tool's own example placeholders and are computed server-side with the formula shown on this page, so the arithmetic can be checked quickly. It demonstrates how to substitute values only — it is not clinical advice and not a real case.
| Witnessed LOC > 5 minutes | No |
|---|---|
| Amnesia > 5 minutes | No |
| Abnormal drowsiness | No |
| ≥ 3 post-traumatic vomits | No |
| Suspicion of non-accidental injury | No |
| Post-traumatic seizure (no prior epilepsy) | No |
| GCS < 14 (< 15 if age < 1 year) | No |
| Suspicion of penetrating injury, depressed skull fracture or tense fontanelle | No |
| Signs of basal skull fracture | No |
| Focal neurologic deficit | No |
| Bruise / swelling / laceration > 5 cm (age < 1 year) | No / N/A |
| High-risk mechanism (RTC >40 mph, fall >3 m, or high-speed projectile) | No |
→CHALICERule-negative — low risk
- Positive items：None
- Age context：Derived for children presenting after head injury
| Witnessed LOC > 5 minutes | Yes |
|---|---|
| Amnesia > 5 minutes | Yes |
| Abnormal drowsiness | Yes |
| ≥ 3 post-traumatic vomits | Yes |
| Suspicion of non-accidental injury | Yes |
| Post-traumatic seizure (no prior epilepsy) | Yes |
| GCS < 14 (< 15 if age < 1 year) | Yes |
| Suspicion of penetrating injury, depressed skull fracture or tense fontanelle | Yes |
| Signs of basal skull fracture | Yes |
| Focal neurologic deficit | Yes |
| Bruise / swelling / laceration > 5 cm (age < 1 year) | Yes |
| High-risk mechanism (RTC >40 mph, fall >3 m, or high-speed projectile) | Yes |
→CHALICECT indicated (rule-positive)
- Positive items：12
- Age context：Derived for children presenting after head injury
Verification & sources · governance
FAQ
Frequently asked questions
- Does CHALICE Pediatric Head Injury Rule upload patient data? Where is it calculated?
- Calculation runs locally in the browser; inputs and results are not uploaded. For licensed clinicians only; interpret with history, investigations and local protocols — not a diagnosis or prescription.
- How is CHALICE Pediatric Head Injury Rule calculated in practice? Can you show a worked example?
- Inputs: Witnessed LOC > 5 minutes No, Amnesia > 5 minutes No, Abnormal drowsiness No, ≥ 3 post-traumatic vomits No, Suspicion of non-accidental injury No, Post-traumatic seizure (no prior epilepsy) No, GCS < 14 (< 15 if age < 1 year) No, Suspicion of penetrating injury, depressed skull fracture or tense fontanelle No… → Result: CHALICE Rule-negative — low risk（Positive items: None, Age context: Derived for children presenting after head injury） Inputs: Witnessed LOC > 5 minutes Yes, Amnesia > 5 minutes Yes, Abnormal drowsiness Yes, ≥ 3 post-traumatic vomits Yes, Suspicion of non-accidental injury Yes, Post-traumatic seizure (no prior epilepsy) Yes, GCS < 14 (< 15 if age < 1 year) Yes, Suspicion of penetrating injury, depressed skull fracture or tense fontanelle Yes… → Result: CHALICE CT indicated (rule-positive)（Positive items: 12, Age context: Derived for children presenting after head injury）