Cover open pneumothorax. Remember, respiratory distress may be due to aspiration of stomach contents. Circulation External haemostasis for lacerations. Ongoing signs of shock warrant urgent blood transfusion. Catheterise bladder and stomach.
Children are more prone to air swallowing and acute gastric dilatation.
Use orogastric rather than nasogastric tube if base of skull fracture is suspected. Take blood for X-match and tests listed below. This is a more thorough assessment to discover less severe injuries and severe, but previously occult, injuries. Look, listen and feel . Remember to feel the fontanelle in babies.