Kid fell off bike: what would you anticipate?

Specialties Emergency

Published

Specializes in ED.

What do you think is the proper course of action for the following scenario:

A 7 year old was on the bike with his brother and they both fell off. His older brother had abrasions to both legs. The 7 year old had an abrasion to the the hand and occipital area of the head. There was no bleeding and no hematoma. The kid ambulated into the ED. He was awake, alert and acting appropriately as per the father. There was no loss of consciousness. No nausea, no vomiting, his gait was steady and his pupils were PERRLA. What do you think the treatment should be?

1) Neuro exam, observation and discharge

2) Neuro exam and head x-ray

3) Neuro exam, IV and Head CT

4) Trauma Code

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Is this homework?

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Specializes in ED.
Is this homework?

No, it's a case study.

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Specializes in ICU, ED, PACU.

Option 1.

Hand abrasion and an occipital impact is very strange though!

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Specializes in Ortho, Case Management, blabla.

I'll pick #3

Neuro exam is a no brainer.

Head CT for concussion (?)

IV just because its a good idea to have an open line just in case.

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Specializes in ICU, ED, PACU.
I'll pick #3

Neuro exam is a no brainer.

Head CT for concussion (?)

IV just because its a good idea to have an open line just in case.

Option 3 must be eliminated as there is no loss of consciousness. Loss of consciousness is the definitive factor of a concussion.

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Specializes in Ortho, Case Management, blabla.
Option 3 must be eliminated as there is no loss of consciousness. Loss of consciousness is the definitive factor of a concision.

I'm not an ER nurse, I work on the floor so I'm used to the messed up people that get admitted. I rarely deal with the light injuries (if this is indeed one) Good point though.

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Specializes in ICU, ED, PACU.

I just want to clarify as to mot mislead anyone. Stage 1 concussion's can have no apparent loss of consciousness, however there must be other neurological symptomes such as amnesia, decrease in LoC, or disorientation.

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Specializes in Emergency & Trauma/Adult ICU.

1. neuro exam, observation & discharge

I would want to know whether or not the kid was helmeted, though.

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Specializes in ED.
1. neuro exam, observation & discharge

I would want to know whether or not the kid was helmeted, though.

No helmet, although he was supposed to have a helmet by law. Oh, and the Vitals were WNL for his age range.

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Specializes in Emergency & Trauma/Adult ICU.
No helmet, although he was supposed to have a helmet by law. Oh, and the Vitals were WNL for his age range.

Then neuro exam, observation, lecture to kiddo & parents by injury prevention nurse (me), and discharge. ;)

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Specializes in ER.

I'd say #3. We would do Xrays if the kid was c/o pain in the legs or arms. Probably do a CT of the head just to cover our a$$es. Maybe a line depending on the doc. It is all about covering the behind. If this were my kid I probably wouldn't have even presented to the ED.

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