According to NICE

-GCS less than 13 at any point since the injury

-GCS equal to 13 or 14 at two hours after the injury.

-Suspected open or depressed skull fracture.

-Any sign of basal skull fracture (haemotympanum, ‘panda’ eyes (black eyes), cerebrospinal fluid otorrhoea, Battle’s sign).

-Post traumatic seizure.

-Focal neurological deficit.

-More than one episode of vomiting

-Amnesia for greater than 30 minutes of events before impact.