A 2-year-old unresponsive child came to casualty with history of fall from a height. On examination, he is responsive to verbal stimuli intermittently, respiratory rate is 30 per min, pulse 130 per min, spO2 is 94% and BP is 104/60 mm Hg. What should be the next step of management?: (A) Observe the child carefully and shift if necessary, (B) Transfer immediately to a tertiary center for CT brain and further management, (C) Start oxygen by face mask, immobilize cervical spine and transfer to a tertiary center accompanied by doctor, (D) Start oxygen by face mask and give mannitol
Answer is C. c. Start oxygen by face mask, immobilize cervical spine and transfer to a tertiary centre accompanied by doctor(Ref: Nelson's 20/e p 545-552)The best management in this case is to supplement O2 as there is hypoxia, to prevent further CNS injury; Cervical spine should be immobilized and the patient should be transferred to a tertiary centre accompanied by doctor.