Case 3

It is 15:00. You are called once again to the resuscitation room to see a 4-year-old girl who has been brought into the department by her parents.

You are told that she was riding her bike 20 minutes ago when she was hit by a car at about 30 mph. She has been very quiet since and has been vomiting repeatedly.

On examination, she is now lying on a trolley. Her eyes are open to speech and she cries when roused. She obeys commands. She has abrasions and contusions to the right side of her head and face and abrasions to her right arm and knee. Her chest, abdominal and pelvic examination are normal.

Her vital signs are:

• HR 115
• BP 98/70
• RR 24
• SpO₂ 94% in air
• GCS 15

Which of the following actions should be performed?

Select one or more options.

The patient's x-rays are shown below.

Click on the x-rays to enlarge.

Report your findings below.

Fig 1: Peg, lateral view	Fig 2: Peg, AP view

Having identified the abnormality, you feel that further radiological assessment is required.

Which of the following statements are true?

Select one or more options.

Looking at the CT scan, what does it confirm and how would you manage this situation?

Click on the CT to enlarge.