Indications for ventilation:

• Oxygen saturation <90%
• Pa02 <8 kPa
• PaCO2 <4 kPa or >6 kPa
• GCS  ? 8

AIRWAY

• Patent airway.
• Cervical spine care.

BREATHING

• Oxygen 100% by mask.

CIRCULATION

• Minimum fluids to achieve circulation.
• Record Pulse, BP and respiratory rate.
• Control external haemorrhage.
• Exclude occult haemorrhage (chest/abdomen/pelvis/lower limbs)

DISABILITY

• Record pupils
• Glasgow Coma Scale.

EXAMINATION

• A lateral cervical spine and chest X-ray.
• CT head for skull fractures, Subdural/ Epidural hematoma
• MRI for multiple haemorrhages of various ages.

• Witnessed Loss of consciousness >5 minutes.
• Amnesia  > 5 minutes.
• Abnormal drowsiness.
• 3 or more episodes of vomiting.
• Non-accidental injury.
• Post-traumatic seizure.
• Age > 1 year: GCS<14.
• Age > 1 year: GCS < 15.
• Any localising sign.
• Suspected skull fracture or tense fontanelle.
• Age < 1 year
• Bruise swelling or laceration > 5 cm on head.
• Dangerous mechanism of injury.