CHALICE Score Calculator

By Dr. Costa / July 10, 2026

CHALICE Rule Calculator

Paediatric head injury

CHALICE Rule Calculator

Predicts clinically important events after head trauma in children, including death, need for neurosurgical intervention, or an abnormal head CT.

Clinical use: Intended for healthcare professionals assessing a child younger than 16 years with a history or signs of head injury. This tool supports—not replaces—urgent clinical assessment, local policy, and specialist judgement.

1 Patient details

Age determines the GCS threshold and whether the infant scalp-injury criterion applies.

Age

CHALICE is intended for children under 16 years.

Current Glasgow Coma Scale (GCS)

Enter the assessed GCS score.

Enter age to display the applicable threshold.

2 History

Select every criterion that is present.

Witnessed loss of consciousness >5 minutes Amnesia >5 minutes Antegrade or retrograde amnesia. Abnormal drowsiness Drowsiness in excess of that expected by the examining clinician. ≥3 vomits after head injury One vomit means one discrete episode of vomiting. Suspicion of non-accidental injury (NAI) Any suspicion of NAI by the examining clinician. Seizure after head injury Applies when there is no previous history of epilepsy.

3 Examination

The GCS criterion is calculated automatically from the age and GCS entered above.

Suspicion of penetrating or depressed skull injury, or tense fontanelle Signs of basal skull fracture Blood or CSF from the ear or nose, panda eyes, Battle’s sign, haemotympanum, facial crepitus, or serious facial injury. Positive focal neurological sign Any focal motor, sensory, coordination, or reflex abnormality. Bruise, swelling, or laceration >5 cm This criterion applies only when the child is younger than 1 year.

4 Mechanism of injury

Select every high-risk mechanism that applies.

High-speed road traffic accident As a pedestrian, cyclist, or occupant; high speed means >40 mph (64 km/h). Fall of >3 m in height High-speed injury from a projectile or object

CHALICE result

Criteria met

Interpretation: CHALICE is a binary decision rule rather than a point score. One or more positive criteria makes the rule positive.

Safety: A negative rule does not exclude every possible injury. Reassess if symptoms evolve or the child deteriorates, and follow local paediatric head-injury guidance.

Reference: Dunning J, Daly JP, Lomas JP, et al. 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. View original study.

Cerebral Perfusion Pressure Calculator

CHEOPS Pain Score Calculator

CURB-65 Score for Pneumonia Severity

June 12, 2025 / Calculator / By Dr. Costa

BMI, BMR, and BSA calculator

June 12, 2025 / Calculator / By Dr. Costa

1 Patient details

2 History

3 Examination

4 Mechanism of injury

Related Posts

Leave a Comment Cancel Reply