Not all kids bounce

Author: Harry Wardell / Editor: Yasmin Sultan / Reviewer: Harry Wardell / Codes: / Published: 02/04/2022

A 3-year-old child is brought to the Emergency Department (ED) by their concerned mother who states that 1 hour ago the child was playing and fell off the top of a slide (3.5m high) hitting their head and landing on the right arm. The child appeared “stunned” for several seconds but then cried and looked for mum to pick them up. Since the accident the child has vomited on 3 separate occasions but has otherwise been well.

The child is asleep when you arrive to examine them but wakes easily to GCS 14 (E3V5M6) and is not drowsy. There is a 5cm swelling to the forehead but otherwise your A to E examination (including central and peripheral neurological exam) is completely normal. The child is reluctant to move the right elbow and your note some swelling and tenderness. The story is convincing for an accident and you are not concerned regarding NAI.

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