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Home Head Trauma-Child
Variants
Scenario Scenario ID Procedure Adult RRL Peds RRL Appropriateness Category
Head trauma, minor, acute, blunt, low risk per PECARN, not abuse, initial imaging 3084022
Radiography skull
<0.1 mSv
☢ 		0.03-0.3 mSv [ped]
☢☢ 		Usually not appropriate
Arteriography cerebral
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
MRA head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CTA head with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Scenario Scenario ID Procedure Adult RRL Peds RRL Appropriateness Category
Head trauma, minor, acute, blunt, GCS=15, severe headache, not abuse, initial imaging 3180657
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		May be appropriate
Radiography skull
<0.1 mSv
☢ 		0.03-0.3 mSv [ped]
☢☢ 		Usually not appropriate
Arteriography cerebral
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
MRA head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CTA head with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Head trauma, minor, acute, blunt, GCS=15, loss of consciousness, not abuse, initial imaging 3180652
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		May be appropriate
Radiography skull
<0.1 mSv
☢ 		0.03-0.3 mSv [ped]
☢☢ 		Usually not appropriate
Arteriography cerebral
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
MRA head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CTA head with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Head trauma, minor, acute, blunt, GCS=15, vomiting, not abuse, initial imaging 3180656
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		May be appropriate
Radiography skull
<0.1 mSv
☢ 		0.03-0.3 mSv [ped]
☢☢ 		Usually not appropriate
Arteriography cerebral
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
MRA head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CTA head with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Head trauma, minor, acute, blunt, GCS=15, scalp hematoma,, not abuse, initial imaging 3180654
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		May be appropriate
Radiography skull
<0.1 mSv
☢ 		0.03-0.3 mSv [ped]
☢☢ 		Usually not appropriate
Arteriography cerebral
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
MRA head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CTA head with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Head trauma, minor, acute, blunt, GCS=15, severe mechanism of injury, not abuse, initial imaging 3180653
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		May be appropriate
Radiography skull
<0.1 mSv
☢ 		0.03-0.3 mSv [ped]
☢☢ 		Usually not appropriate
Arteriography cerebral
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
MRA head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CTA head with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Head trauma, minor, acute, blunt, GCS=15, abnormal behavior per parents, not abuse, initial imaging 3180655
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		May be appropriate
Radiography skull
<0.1 mSv
☢ 		0.03-0.3 mSv [ped]
☢☢ 		Usually not appropriate
Arteriography cerebral
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
MRA head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CTA head with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Scenario Scenario ID Procedure Adult RRL Peds RRL Appropriateness Category
Head trauma, minor, acute, blunt, basilar skull fracture suspected, not abuse, initial imaging 3180660
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
Radiography skull
<0.1 mSv
☢ 		0.03-0.3 mSv [ped]
☢☢ 		Usually not appropriate
Arteriography cerebral
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
MRA head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CTA head with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Head trauma, minor, acute, blunt, GCS=14, not abuse, initial imaging 3180658
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
Radiography skull
<0.1 mSv
☢ 		0.03-0.3 mSv [ped]
☢☢ 		Usually not appropriate
Arteriography cerebral
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
MRA head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CTA head with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Head trauma, minor, acute, blunt, altered mental status, not abuse, initial imaging 3180659
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
Radiography skull
<0.1 mSv
☢ 		0.03-0.3 mSv [ped]
☢☢ 		Usually not appropriate
Arteriography cerebral
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
MRA head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CTA head with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Scenario Scenario ID Procedure Adult RRL Peds RRL Appropriateness Category
Head trauma, moderate to severe, acute, blunt, GCS<=13, not abuse, initial imaging 3164929
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
Radiography skull
<0.1 mSv
☢ 		0.03-0.3 mSv [ped]
☢☢ 		Usually not appropriate
Arteriography cerebral
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
MRA head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CTA head with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Scenario Scenario ID Procedure Adult RRL Peds RRL Appropriateness Category
Head trauma, subacute, blunt, cognitive or neurologic signs, initial imaging 3084025
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
Radiography skull
<0.1 mSv
☢ 		0.03-0.3 mSv [ped]
☢☢ 		Usually not appropriate
Arteriography cerebral
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
MRA head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CTA head with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Scenario Scenario ID Procedure Adult RRL Peds RRL Appropriateness Category
Head trauma, chronic, blunt, new or progressive neurologic deficit, not abuse or post traumatic seizure 3164930
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRA head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
(Disagreement)
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
(Disagreement)
MRI head without IV contrast with DTI
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
(Disagreement)
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		May be appropriate
(Disagreement)
Radiography skull
<0.1 mSv
☢ 		0.03-0.3 mSv [ped]
☢☢ 		Usually not appropriate
Arteriography cerebral
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
MR spectroscopy head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI functional (fMRI) head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CTA head with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
FDG-PET/CT brain
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
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