A 10-year-old child falls from a tree and hits their head on the ground. The child loses consciousness briefly but regains consciousness within a minute. On examination, there is a large scalp hematoma and no other visible injuries. The child is alert and oriented, has no focal neurological deficits, and is speaking coherently. What is the most appropriate next step in the management of this child? A. Immediate surgical evacuation of the scalp hematoma B. Observation and serial neurological assessments C. . Emergent computed tomography (CT) scan of the head D. Administration of mannitol to reduce intracranial pressure E. Initiation of anticoagulant therapy to prevent clot formation Answer: C. Emergent computed tomography (CT) scan of the head Explanation: In a child with head trauma and loss of consciousness, the most appropriate next step is an emergent CT scan of the head to evaluate for intracranial injuries, such as epidural or subdural hematoma. While scalp hematoma may be present, it is not typically the primary concern. Observation and serial neurological assessments may be appropriate after the initial CT scan if no intracranial injuries are detected. Immediate surgical evacuation of the scalp hematoma is not indicated unless it is causing significant compression. Mannitol and anticoagulant therapy are not appropriate initial steps in the management of head trauma in this scenario.
