Approach to traumatic brain injury (pediatrics) Quiz: Ace Your Exams

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A 9-year-old boy is brought to the emergency department by his parent for evaluation of a closed head injury. He was on a sled traveling downhill when he collided with a tree striking his forehead on the ground. He was not wearing a helmet and lost consciousness for about 30 seconds. The patient has no significant past medical history and takes no medication. Temperature is 37.5°C (99.5°F), pulse is 110/min, respirations are 22/min, blood pressure is 100/75 mmHg, and oxygen saturation is 99% on room air. Upon arrival, a cervical collar is placed. The patient is speaking in clear full sentences but appears confused. There is a large hematoma over the forehead. The patient is moving all extremities spontaneously and localizes to pain and opens his eyes spontaneously. A full head-to-toe examination does not reveal any further injury or trauma. Which of the following is the best next step in management? 

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