Table 1 Comparison of inclusion criteria, exclusion criteria and clinical predictors between the Australasian Paediatric Head Injury Rules Study (APHIRST) cohort and the Scandinavian Neurotrauma Committee (SNC) guidelines

All children < 18 years, all GCS

All children < 18 years with head injury within 24 h of trauma, GCS 9–15

 Trivial facial injury only

Prior imaging

 Referral from ER to external provider

 Neuroimaging before transfer to site

 Did not wait to be seen

 GCS 9–13

GCS 9–13

 GCS 14

GCS 14

 Positive focal neurology

Focal neurological deficit

 Seizure in patient with no history of epilepsy

Post-traumatic seizures

(Clinical signs of basal skull fracture) OR (suspicion of penetrating or depressed skull injury)

Clinical signs of skull base fracture or depressed skull fracture

 LOC > 5 s

LOC > 1 min

 Any bleeding disorder or anticoagulation therapy

Anticoagulation or coagulation disorder

 Amnesia (antegrade or retrograde; > 5 min)

Post-traumatic amnesia

 (Severe headache) OR (history of worsening headache)

Severe/progressive headache

 Not acting normally per parent report

Abnormal behaviour according to guardian

 Vomiting ≥ 2 episodes

Vomiting ≥ 2 episodes

 Any or suspected LOC

Suspected/brief LOC

 Shunt

Shunt

 (Age < 2 and irritability on examination) OR (age < 2 and temporal or parietal hematoma) OR (age < 2 and large, boggy scalp hematoma)

If age < 2 years, large, temporal or parietal scalp hematoma OR irritability

 Combination of at least two risk factors from the SNC predictors

Multiple risk factors