🧠 CHIP Rule (CT in Minor Head Injury)
UseWhen to use: adults GCS 13–15 within hours of blunt head trauma.
StrataAny major or ≥2 minor → CT; otherwise CT not indicated by CHIP alone.
LimitsWhen not to use: GCS ≤12, age <16, penetrating injury. · Pitfall: missing anticoagulant use. · Clinical concern overrides.
SourceCHIP rule (Smits et al., Ann Intern Med)
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
Major vs minor.
When to use
When to use: adults GCS 13–15 within hours of blunt head trauma.
How it works
CT if ≥1 major or ≥2 minor CHIP criteria.
Key points
- Major vs minor.
- Threshold 1 / 2.
- Next: CT or observe.
References
- CHIP rule (Smits et al., Ann Intern Med)
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.
| Major: pedestrian/cyclist vs vehicle | No (0) |
|---|---|
| Major: ejected from vehicle | No (0) |
| Major: vomiting | No (0) |
| Major: post-traumatic amnesia ≥4 h | No (0) |
| Major: clinical skull-fracture signs | No (0) |
| Major: GCS <15 | No (0) |
| Major: GCS drop ≥2 at 1 h | No (0) |
| Major: anticoagulant therapy | No (0) |
| Major: post-traumatic seizure | No (0) |
| Major: focal neurologic deficit | No (0) |
| Minor: fall from any elevation | No (0) |
| Minor: persistent anterograde amnesia | No (0) |
| Minor: PTA 2–4 h | No (0) |
| Minor: skull contusion | No (0) |
| Minor: loss of consciousness | No (0) |
| Minor: GCS drop of 1 at 1 h | No (0) |
| Minor: age 40–60 y | No (0) |
| Minor: age ≥60 y | No (0) |
→CHIPCT no
- Major / minor：0 / 0
- Cue：CT not indicated by CHIP alone (0 major and ≤1 minor)
| Major: pedestrian/cyclist vs vehicle | Yes (+1) |
|---|---|
| Major: ejected from vehicle | Yes (+1) |
| Major: vomiting | Yes (+1) |
| Major: post-traumatic amnesia ≥4 h | Yes (+1) |
| Major: clinical skull-fracture signs | Yes (+1) |
| Major: GCS <15 | Yes (+1) |
| Major: GCS drop ≥2 at 1 h | Yes (+1) |
| Major: anticoagulant therapy | Yes (+1) |
| Major: post-traumatic seizure | Yes (+1) |
| Major: focal neurologic deficit | Yes (+1) |
| Minor: fall from any elevation | Yes (+1) |
| Minor: persistent anterograde amnesia | Yes (+1) |
| Minor: PTA 2–4 h | Yes (+1) |
| Minor: skull contusion | Yes (+1) |
| Minor: loss of consciousness | Yes (+1) |
| Minor: GCS drop of 1 at 1 h | Yes (+1) |
| Minor: age 40–60 y | Yes (+1) |
| Minor: age ≥60 y | Yes (+1) |
→CHIPCT yes
- Major / minor：10 / 8
- Cue：CT indicated by CHIP (≥1 major or ≥2 minor)
Verification & sources · governance
FAQ
Frequently asked questions
- Does CHIP Rule (CT in Minor Head Injury) 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 CHIP Rule (CT in Minor Head Injury) calculated in practice? Can you show a worked example?
- Inputs: Major: pedestrian/cyclist vs vehicle No (0), Major: ejected from vehicle No (0), Major: vomiting No (0), Major: post-traumatic amnesia ≥4 h No (0), Major: clinical skull-fracture signs No (0), Major: GCS <15 No (0), Major: GCS drop ≥2 at 1 h No (0), Major: anticoagulant therapy No (0)… → Result: CHIP CT no（Major / minor: 0 / 0, Cue: CT not indicated by CHIP alone (0 major and ≤1 minor)） Inputs: Major: pedestrian/cyclist vs vehicle Yes (+1), Major: ejected from vehicle Yes (+1), Major: vomiting Yes (+1), Major: post-traumatic amnesia ≥4 h Yes (+1), Major: clinical skull-fracture signs Yes (+1), Major: GCS <15 Yes (+1), Major: GCS drop ≥2 at 1 h Yes (+1), Major: anticoagulant therapy Yes (+1)… → Result: CHIP CT yes（Major / minor: 10 / 8, Cue: CT indicated by CHIP (≥1 major or ≥2 minor)）