Key Learning Points

1. 1. Trauma is the leading cause of death in children older than 1 year.

2. 2. An isolated head injury is the most common presentation of major trauma.

3. 3. Consider non-accidental injury in all children, particularly in those <2 years.

4. 4. Have a high index of suspicion for cervical spine injury, and consider spinal cord injury without radiographic abnormality (SCIWORA) in younger children.

5. 5. If cervical spine injury is suspected in the comatose child, immobilisation should be continued until adequate imaging and/or clinical assessment can be performed.

Key Learning Points

1. 1. Initial assessment and management of a trauma patient require a structured team approach, with good communication and leadership. Often this is best coordinated by someone standing back from the action, and thus able to take account of the whole unfolding scenario.

2. 2. All members should have appropriate personal protection equipment, especially with the recent global coronavirus disease (COVID-19) pandemic.

3. 3. The primary survey using an ABCDE approach is undertaken with the aim to rule out, and treat, any life-threatening injuries.

4. 4. Once the patient has been stabilised with regard to the initial insult, then a full head-to-toe secondary survey examination needs to be performed to identify, treat and document any remaining injuries present.

5. 5. It is important to ask the question: ‘Do the patient’s treatment needs exceed the capability of this receiving institution?’. If the answer is yes, then urgent referral should be made to a major trauma centre.