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Demo Question
A 9-year-old boy fell from a height of 2m landing on his head on the concrete. On examination there is no obvious limb injury or visible haemorrhage. Heart rate is 100/min, respiratory rate 16/min and he is unresponsive to pain.
What is the best next step?
Head tilt/chin lift followed by airway clearance
Jaw thrust followed by airway clearance
Inline stablisation followed by jaw thrust and airway clearance
Head tilt/chin lift followed by inline stabilisation
Jaw thrust followed by inline stabilisation then airway clearance
Key Learning Point
Know how to differentiate between life or limb-threatening injuries and injuries that can be managed less urgently
Explanation
The history suggests a fall from a significant height onto the head impacting a hard surface, with markedly reduced level of consciousness in a patient who is unable to protect his own airway. A cervical spine injury should be suspected. Inline stabilisation should be performed followed by a jaw thrust and removal of objects from the mouth. Head tilt/chin lift should be avoided, as this can exacerbate cervical spine injury.
[FEmgM9] Know how to differentiate between life or limb-threatening injuries and injuries that can be managed less urgently
