Kid fell off bike: what would you anticipate?

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

Up Vote Up Vote ×

Is this homework?

Up Vote Up Vote ×
Specializes in ED.
Is this homework?

No, it's a case study.

Up Vote Up Vote ×
Specializes in ICU, ED, PACU.

Option 1.

Hand abrasion and an occipital impact is very strange though!

Up Vote Up Vote ×
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.

Up Vote Up Vote ×
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.

Up Vote Up Vote ×
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.

Up Vote Up Vote ×
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.

Up Vote Up Vote ×
Specializes in Emergency & Trauma/Adult ICU.

1. neuro exam, observation & discharge

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

Up Vote Up Vote ×
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.

Up Vote Up Vote ×
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. ;)

Up Vote Up Vote ×
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.

Up Vote Up Vote ×
+ Join the Discussion