The GCS on initial evaluation is 15. What is the appropriate next inv?

A 3yo child has been brought with facial lacerations. On examination he has some cuts over his

right cheek and under the eye. The GCS on initial evaluation is 15. What is the appropriate next

inv?

a. Skull XR

b. Facial XR

c. CT scan

d. MRI

e. Observation

Ans. The key is B. Facial X-ray. [Normal GCS makes intracranial lesion less likely. As there is facial injury to exclude any facial bone fracture we can do facial X-ray].