A male student has been brought in by ambulance on a Saturday night, he has been out drinking and got into a fight. He has obvious evidence of an external head injury.

His initial GCS is E3 V4 M6 (13). After 90 mins in the department his GCS remains unchanged.


Answer one question before attending the face-to-face teaching session. Add comments to answers already given if you think it's appropriate. The first part of teaching will be spent discussing this case:

  1. What are the essential components of your examination of this patient?

  2. Would you CT his head? (Please explain your answer)

  3. What are the minimum components of neuro-observations?

  4. In this case what is the recommended duration and frequency of neuro-observations?

  5. The next morning he feels better and is more alert You diagnose concussion, what advice would you give on discharge?

  6. During the observation period what changes would trigger a further assessment or CT?