Identifies low-risk blunt head trauma where CT can be avoided. Any positive predictor = not low risk.
The NEXUS II — Paediatric Head CT Rule is a radiology scoring tool used in paediatric practice. Identifies low-risk blunt head trauma where CT can be avoided. Any positive predictor = not low risk. It scores 7 criteria and interprets the total across 2 bands, so the number always arrives with the severity it implies rather than on its own. In PediAid each criterion is shown as a labelled option with the weight it carries, so the total can be checked rather than taken on trust.
7. They are Evidence of significant skull fracture; Altered level of alertness; Neurological deficit; Persistent vomiting; Presence of scalp haematoma; Abnormal behaviour; and others.
The total is interpreted as: any score - Low risk - CT may be avoided: no predictors - very low risk of clinically important intracranial injury (sensitivity ~98-100%). CT can reasonably be withheld with observation; 1 predictor or more - Not low risk: one or more predictors - NOT low risk. CT head is indicated, or observation with a low threshold to image.
No. It is a structured way to record and communicate severity. A clinician concerned about a child should act on that concern regardless of the total.
Source: Oman JA et al. Performance of a decision rule to predict need for computed tomography among children with blunt head trauma (NEXUS II). Pediatrics 2006;117:e238-46.
Yes. Score definitions are bundled with the PediAid app, so the score computes without a connection.