Algorithm for Management of Head Injuries in Children
Primary ...
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Description

Algorithm for Management of Head Injuries in Children

Primary survey:

 • Airway and cervical spine

 • Breathing

 • Circulation and haemorrhage control

 • Disability:

   - consciousness

   - pupils

 • Exposure

Potentionally serious head injury:

 • Witnessed loss of consciousness >5 min

 • Amnesia >5 min

 • Abnormal drowsiness

 • 3 or more discrete episodes of vomiting

 • Clinical suspicion of non-accidental injury 

 • Post-traumatic seizure but no history of epilepsy

 • Glasgow Coma Score < 15 (<14 if <1 year old)

 • Suspicion of open/depressed skull injury/tense fontanelle

 • Sign of basal skull fracture, e.g. CSF leak from nose/ears, purple around eyes (panda eyes) or over mastoid (Battle sign) or ear drum (haemotympanum)

 • < 1 year old and bruise/swelling >5 cm on head

 • Dangerous mechanism — high-speed road traffic accident, fall from >3 m, high-speed injury from projectile object.



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