MRI however, should be avoided in patients that may have implants in the brain or cranium (NGI, 2006). While unlikely in a pediatric patient, if evidence that such a device cannot be confirmed through conversation with relatives, CT imaging and X-Ray imaging may be the best tools to assess damage to the brain and surrounding regions. Radio imaging will also provide assessment and evaluation of cervical spine fractures should they exist. The risk factors in this patient's condition include possible concussion and internal bleeding, in and around the head, but also of internal organs that may have experienced damage on impact during the car accident. For example, the patient may start vomiting due to excitement or abdominal injury (NICE, 2003). Assessment should include diagnoses of irrational behavior. While fear and distress are likely to be present, other emotions that seem out of the ordinary should be noted during assessment when evaluating further risk factors for these patients. If the patient's parents or relatives are available, they can serve as calming agents and help medical assessment teams evaluate whether certain behaviors are within the "norm" for the patient or not.

Any patient sustaining a head injury is at risk for swelling of the brain, internal bleeding, neurological impairment, and paralysis. Paralysis and other injuries may occur resulting from damage to the cervical spine during injury. Damage to the cervical spine may depend on the nature of the head injury, the force of...

In cases involving children, as symptoms are sometimes hard to evaluate, an overnight stay for observation may be recommended to ensure the patient remains safe, and to evaluate further the patient's risk for coma. Most patient's sustaining a head injury are kept awake to prevent the potential for this, thus medical providers may also want to monitor the patient consistently to help evaluate the risk of coma for this patient (NICE, 2003). If all scans and imaging come back normal, and within a few hours, the patient acts normal and shows no outward signs of severe injury, there is still the potential for injury. Parents or care providers should be provided proper information and guidance as to signs to look for that may suggest latent injury. Follow up care is also important with the patient's primary medical provider within the days following the injury.
References

National Collaborating Centre for Acute Care. (2003, June). Head injury: triage, assessment & early management of head injury in infants, children & adults. London: National Institute for Clinical Excellence, NICE. P. 248.

NGC. (2006) Head injury: triage, assessment, & investigation. National Guideline

Clearinghouse, Available:

http://www.guideline.gov/summary/summary.aspx?ss=15&doc_id=5067&nbr=3551

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