The expanded Denver criteriaa
| Signs/Symptoms | Risk Factors |
|---|---|
| Potential arterial hemorrhage from face or neck | High-energy trauma mechanism with: |
| Cervical bruit in patient <50 yr | LeFort II or III facial fracture |
| Expanding cervical hematoma | Mandible fracture |
| Neurologic deficit inconsistent with head CT | Complex skull or skull base fracture |
| Stroke on CT or MRI | Severe TBI with GCS < 6 |
| Cervical spine fracture, subluxation, or ligamentous injury at any level | |
| Near hanging with anoxic brain injury | |
| Clothesline type injury or seat belt abrasion with significant swelling, pain, or altered mental status | |
| TBI with thoracic injuries | |
| Scalp degloving | |
| Thoracic vascular injury | |
| Blunt cardiac rupture | |
| Upper rib fractures |
Note:—TBI indicates traumatic brain injury; GCS, Glasgow Coma Scale.
↵a Adapted from Nagpal et al.37