* Persistent vomiting or increasing headache post injury
All children with head injuries * Fractured skull * Penetrating skull trauma * Deterioration in conscious state following injury * Focal neurological signs * Confusion or impairment of consciousness > 30 minutes * Loss of consciousness > 5 minutes * Persistent vomiting or increasing headache post injury * Any convulsive movements * More than one episode of concussive injury in a game or training session * Where there is assessment difficulty (eg: an intoxicated patient) * High risk patients (eg: hemophilia, anticoagulant use) * Inadequate post injury supervision * High risk injury mechanism (eg: high velocity impact, missile injury)