Table 1.

The PediBIRN 4-variable clinical decision rule for abusive head trauma.

To minimize missed cases, every acutely head-injured infant or young child hospitalized for intensive care who presents with one or more of these 4 predictor variables should be considered higher risk and thoroughly evaluated for abuse.

Any clinically-significant respiratory compromise at the scene of injury, during transport, in the Emergency Department, or prior to admission

Any bruising involving the child’s torso, ear(s), or neck

Any subdural hemorrhage(s) or fluid collection(s) that are bilateral or involve the interhemispheric space

Any skull fracture(s) other than an isolated, unilateral, nondiastatic, linear, parietal skull fracture

Abbreviations: PediBIRN=pediatric brain injury research network