The child with a decreased consciousness and evidence of trauma should be managed as per APLS [5] /ATLS [7] and the NICE head injury guidelines. [14]
In the infant, trauma may not be immediately obvious, for example in the cases of non-accidental injury (NAI), where the history may not correlate. Children may be treated for other causes of reduced consciousness, e.g. sepsis, before the diagnosis is discovered. [7, 15]