CHALICE Pediatric Head-Injury Rule
CHALICE rule (Children's Head injury ALgorithm for the prediction of Important Clinical Events) — CT head recommended if any one of 14 high-risk history, examination, or mechanism criteria is present in a child with head injury.
Open the calculator → Runs in your browser. Data leaves only if you deliberately send a problem report from the interactive tool.
Example
- Witnessed loss of consciousness > 5 min
- Yes
Result: CHALICE positive — CT head recommended by the rule (1 of 14 criteria present).
The tool opens with these values already filled in. Replace them with your own.
What the result means
- Any of 14 positive
- CT head recommended by the rule (~98% sensitivity for a clinically significant intracranial injury).
- All 14 absent
- CT not required by the rule. A rule result, not an imaging order.
What you enter
- Witnessed loss of consciousness > 5 min
- Amnesia > 5 min
- Abnormal drowsiness
- >= 3 vomits after injury
- Suspicion of non-accidental injury
- Post-traumatic seizure without epilepsy history
- GCS < 14 (or < 15 if age < 1 year)
- Suspected penetrating/depressed skull injury or tense fontanelle
The other 6 fields
- Signs of a basal skull fracture
- Positive focal neurology
- Bruise/swelling/laceration > 5 cm if age < 1 year
- High-speed road-traffic accident (> 40 mph)
- Fall > 3 m
- High-speed projectile or object
How this is calculated
Dunning J, Daly JP, Lomas J-P, Lecky F, Batchelor J, Mackway-Jones K. Derivation of the children’s head injury algorithm for the prediction of important clinical events decision rule for head injury in children. Arch Dis Child. 2006;91(11):885-891. Read the source ↗
A reference and educational tool. Not medical, legal, or financial advice, and not a substitute for clinician judgment.