CATCH 儿童头部 CT 规则
用途适用： children with minor head injury (GCS 13–15) plus LOC, amnesia, disorientation, vomiting, or irritability …
分层High-risk targets neurosurgical intervention; medium-risk targets CT-visible brain injury. Rule-negative is l…
局限不适用： obvious major trauma, GCS ≤12, or pathways that mandate PECARN/N… · 易错点： applying CATCH to trivial bumps without derivation entry feature… · Local imaging capacity and radiation stewardship matter.
出处Osmond MH, et al. CMAJ 2010 (CATCH)
本班次下一步
评完分数后：进场景连算、看相邻评分、打开对应路径。本地参考，不写入 HIS。
方法学 · 公式代入、指南要点与完整说明
适用场景
适用： children with minor head injury (GCS 13–15) plus LOC, amnesia, disorientation, vomiting, or irritability — as in derivation.
需要填写的项目
- High: GCS < 15 at 2 h after injury · 选项
- High: Suspected open or depressed skull fracture · 选项
- High: History of worsening headache · 选项
- High: Irritability on examination · 选项
- Medium: Any sign of basal skull fracture · 选项
- Medium: Large boggy scalp hematoma · 选项
- Medium: Dangerous mechanism (MVC; fall ≥3 ft / 5 stairs; fall from bicycle without helmet) · 选项
- CATCH2 add-on: ≥ 4 discrete vomiting episodes · 选项
计算方法与公式
High (any → CT): GCS <15 at 2 h; suspected open/depressed skull fx; worsening headache; irritability. Medium (CT vs observe): basal skull-fx signs; large boggy scalp hematoma; dangerous mechanism; CATCH2 adds ≥4 vomits.
Score at bedside; any high-risk factor favors CT. Medium-risk: shared decision CT vs observation. Document safeguarding.
公式代入演示
下列数值取自本工具各输入项的示例值，用本页公式在服务端实际算出，供快速核对计算过程。仅演示代入方法，不构成临床建议，也不代表任何真实病例。
| High: GCS < 15 at 2 h after injury | 否 (0) |
|---|---|
| High: Suspected open or depressed skull fracture | 否 (0) |
| High: History of worsening headache | 否 (0) |
| High: Irritability on examination | 否 (0) |
| Medium: Any sign of basal skull fracture | 否 (0) |
| Medium: Large boggy scalp hematoma | 否 (0) |
| Medium: Dangerous mechanism (MVC; fall ≥3 ft / 5 stairs; fall from bicycle without helmet) | 否 (0) |
| CATCH2 add-on: ≥ 4 discrete vomiting episodes | 否 (0) |
→CATCHRule-negative — low risk
- High-risk hits：0
- Medium-risk hits：0
| High: GCS < 15 at 2 h after injury | Yes — high risk |
|---|---|
| High: Suspected open or depressed skull fracture | Yes — high risk |
| High: History of worsening headache | Yes — high risk |
| High: Irritability on examination | Yes — high risk |
| Medium: Any sign of basal skull fracture | Yes — medium risk |
| Medium: Large boggy scalp hematoma | Yes — medium risk |
| Medium: Dangerous mechanism (MVC; fall ≥3 ft / 5 stairs; fall from bicycle without helmet) | Yes — medium risk |
| CATCH2 add-on: ≥ 4 discrete vomiting episodes | Yes — CATCH2 medium |
→CATCHHigh risk — CT recommended
- High-risk hits：4
- Medium-risk hits：4
- CATCH2 vomit≥4：是
结果判读与分层
High-risk targets neurosurgical intervention; medium-risk targets CT-visible brain injury. Rule-negative is low risk but not zero — give observation advice.
指南要点（原创整理）
- 4 high + 3 medium (+ CATCH2 vomit≥4).
- Any high → CT.
- 下一步： PECARN / CHALICE / neurosurgery.
以上为依据相应指南的关键推荐、由本站用自己的语言归纳整理（非指南原文）；完整内容请见下方官方来源。
注意事项与局限
- 不适用： obvious major trauma, GCS ≤12, or pathways that mandate PECARN/NICE instead.
- 易错点： applying CATCH to trivial bumps without derivation entry features.
- Local imaging capacity and radiation stewardship matter.
核对与出处 · 可验证治理
参考指南与出处
- Osmond MH, et al. CMAJ 2010 (CATCH) · 来源 ↗
- CATCH2 refinement CMAJ 2018 (adds ≥4 vomits)
指南全文版权归相应学会/期刊所有；本工具仅实现其决策算法并注明出处，全文请经上方官方来源获取。
依据文献年份见参考 · 数据集整理日 2026-10-08
常见问题
常见问题
- CATCH 儿童头部 CT 规则的计算是否上传患者数据？在哪里计算？
- 计算在浏览器本地完成，输入与结果不上传服务器；结果仅供执业医师参考，须结合病史、检查与本机构方案判断，不构成诊断或处方依据。
- CATCH 儿童头部 CT 规则怎么代入计算？能举个例子吗？
- 代入: High: GCS < 15 at 2 h after injury 否 (0)、High: Suspected open or depressed skull fracture 否 (0)、High: History of worsening headache 否 (0)、High: Irritability on examination 否 (0)、Medium: Any sign of basal skull fracture 否 (0)、Medium: Large boggy scalp hematoma 否 (0)、Medium: Dangerous mechanism (MVC; fall ≥3 ft / 5 stairs; fall from bicycle without helmet) 否 (0)、CATCH2 add-on: ≥ 4 discrete vomiting episodes 否 (0) → 结果: CATCH Rule-negative — low risk（High-risk hits: 0、Medium-risk hits: 0） 代入: High: GCS < 15 at 2 h after injury Yes — high risk、High: Suspected open or depressed skull fracture Yes — high risk、High: History of worsening headache Yes — high risk、High: Irritability on examination Yes — high risk、Medium: Any sign of basal skull fracture Yes — medium risk、Medium: Large boggy scalp hematoma Yes — medium risk、Medium: Dangerous mechanism (MVC; fall ≥3 ft / 5 stairs; fall from bicycle without helmet) Yes — medium risk、CATCH2 add-on: ≥ 4 discrete vomiting episodes Yes — CATCH2 medium → 结果: CATCH High risk — CT recommended（High-risk hits: 4、Medium-risk hits: 4、CATCH2 vomit≥4: 是）
核对流程与方法学
核对与依据
本工具的公式与计算方法已在本页明示、公开可逐一核查。其公式、系数与阈值依据上方「参考指南与出处」列出的权威来源核对。想了解本站对全部临床工具的核对流程与出处覆盖情况，见 临床工具核对表与方法学 →