Case 1


Your unit responds to a child who fell down the stairs. On arrival you are met by an anxious mother who states that her 5-year-old son left the basement door open and her 8-month-old son went through the open door in his walker and fell down the flight of stairs. Your initial assessment finds a conscious 8-month-old child in his mother's arms, he is not crying and does not respond to your presence or his mother's voice.

What injury are you most concerned about given the mechanism, child's anatomy and presentation?