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Paediatrics Emergency Medicine Strong — NICE CG176 / Osmond 2010

CATCH Rule — Paediatric Head CT

Canadian Assessment of Tomography for Childhood Head injury. Guides CT head in children ≥ 2 years with minor head injury (GCS 13–15).

High-risk = CT required

Medium-risk = CT for detection of brain injury (but not requiring neurosurgery alone)

Score interpretation

Low Risk — CT Not Required 0–1

No high-risk or medium-risk factors. CT head not required.

→ Observe in ED for minimum 4–6 hours. Discharge with head injury advice sheet if GCS 15 and improving. Return if: vomiting, worsening headache, drowsiness, seizure.

Medium Risk — CT Recommended 2–4

Medium-risk factor present. CT head recommended to detect brain injury.

→ CT head within 1–4 hours. Neurosurgery referral if abnormality found. Observe minimum 4–6 hours post-CT.

High Risk — Urgent CT Required 5–99

High-risk factor present. Urgent CT head required — possible neurosurgical injury.

→ URGENT CT head (within 1 hour). Immediate neurosurgery referral. PICU involvement if GCS < 13. Safeguarding if mechanism inconsistent with injury.

Interpretation bands for the CATCH Rule. Apply clinical judgement and local guidance.

References

Related

Curated clinical cross-links plus same-class fallbacks.

Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.