CHIP (CT in Head Injury Patients) Prediction Rule
Predicts which adult head injury patients require CT imaging. Validated Dutch decision rule with high sensitivity (100%) for intracranial traumatic findings.
Score interpretation
No major or minor CHIP criteria met -- CT not indicated
→ No CT required; patient may be discharged with head injury advice; written instructions for return if: worsening headache, repeated vomiting, seizure, drowsiness, focal weakness, CSF leak, confusion; GP follow-up if any persistent symptoms; NICE guidance recommends 4-6 hours observation minimum if any LOC.
One or more CHIP criteria present -- CT head required
→ Perform CT head urgently (within 1 hour if major criteria; within 8 hours if minor criteria only -- per NICE NG232); neurosurgical referral if CT shows: intracranial haemorrhage, depressed skull fracture, contusion, subarachnoid blood; admit for monitoring if positive CT; GCS and neuro obs every 30 minutes; senior review within 1 hour.
Interpretation bands for the CHIP Rule. Apply clinical judgement and local guidance.
References
- Smits M et al. External validation of the Canadian CT Head Rule and the New Orleans Criteria for CT scanning in patients with minor head injury. JAMA. 2005;294(12):1519-1525.
- NICE NG232. Head injury: assessment and early management. NICE. 2023.
Related
Curated clinical cross-links plus same-class fallbacks.
- Tranexamic Acid (ICU/Trauma/Surgical) · Antifibrinolytic
- Cetuximab · Anti-EGFR Monoclonal Antibody — Head and Neck Cancer
- Cisplatin · Platinum Chemotherapy — Head and Neck Cancer
- Methotrexate · Chemotherapy / Immunosuppressant — Head and Neck / Granulomatosis
- Pembrolizumab (Head and Neck SCC) · PD-1 Inhibitor
- Nivolumab (Head and Neck SCC) · PD-1 Inhibitor
- Acute Stroke / TIA Assessment · NICE NG128; RCP Stroke Guidelines 2023
- Status Epilepticus (Adults) · NICE CG137; ESEM guidelines; RCP Neurology Guidelines
- Suspected Subarachnoid Haemorrhage · NICE NG228; RCEM 2023; AHA/ASA 2023
- Adult Head Injury · NICE NG232 (2023)
- Bell's Palsy / Facial Nerve Palsy · ENT UK 2017; AAN
- Vertigo Workup · ENT UK; NICE CKS
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.