, A. Cervical spine films and CT of the head
7-year-old girl is found at the
bottom of a swimming pool.
Initially she was in full arrest but
after 5 minutes she showed sinus
tachycardia but no respiratory
effort. Intubation was done in the
field and cervical collar placed.
After transport to the emergency
department she was unresponsive
with a blood pressure of 100/60
mmHg, pulse 105, temperature
34.3C, and oxygen saturation
100%. The pupils were 3 mm and
sluggishly responsive to light.
There is no response to pain. The
lungs show wheezing on the left
and coarse breath sounds
bilaterally. The monitor shows
sinus tachycardia. There is no
rectal tone. Which of the following
should be the next step in
management?
A. Cervical spine films and CT of
the head B. Portable chest
radiograph
C. Arterial blood gas
D. Right and left decubitus chest
radiographs
, B. CT abdomen
An 8-year old child is brought to
the ER after being struck by a car
while crossing the street. He is not
alert and required immediate
intubation at the scene by EMS.
His GCS is 8 T. He appears to
have a significant laceration of his
scalp on the left side but there are
no skeletal fractures. The initial
chest x-ray revealed a right sided
pneumothorax and a chest tube
was inserted. His hematocrit is
23.5 and hemoglobin is 7.6. The
next thing you would do is:
A. CT head
B. CT abdomen
C. Repeat blood work
D. Observe patient
, B. CT of the head
A 13 year old boy fell while riding
his bicycle and hit his head. He
was unconscious for 4 or 5
minutes. He vomited twice. He has
no memory of the event or a
headache. His exam is entirely
normal. Glasgow coma score is
15. Select the next step in
management.
A. Discharge home with
concussion instructions
B. CT of the head
C. Skull films
D. Admit for observation
8
A 17-year-old male is hit on the
head with a baseball bat. He
withdraws and opens his eyes in
response to deep painful stimuli.
He also mumbles
incomprehensibly. What is his
Glasgow coma scale score?