Paramedic National Registry Practice

A pediatric patient fell down the stairs and is complaining of leg pain while showing altered mental status. What is your main concern?

1. Spinal injury

2. Internal bleeding

3. Head injury

4. Leg fracture

The correct answer is: Head injury

In this scenario, the primary concern should be a head injury, given the context of the mechanism of injury—specifically, a fall down the stairs. Pediatric patients, due to their developing anatomy and physiology, are at a higher risk for head injuries when they experience falls, especially from a height. Altered mental status can be indicative of head trauma, such as a concussion or more severe brain injury, which may not always present with obvious physical symptoms. In cases where a patient exhibits altered mental status, it is vital to prioritize the assessment of potential intracranial injuries. Ensuring that the patient's airway, breathing, and circulation are stable is crucial, while also closely monitoring for any signs of neurological impairment. Other injuries, such as fractures or internal bleeding, can be serious; however, the immediate concern with altered mental status following a fall is the possibility of head trauma, which could lead to complications such as prolonged unconsciousness or life-threatening hemorrhages within the skull. Utilizing this focus allows for a systematic approach to emergency care, prioritizing interventions that could mitigate more severe outcomes associated with head injuries.