ffAssess mechanism of injury to assess risks of severe injury (which may not be apparent at the beginning) ffAssess medical history to assess risk of complication (e.g., elderly, anticoagulant treatment etc.) ffAssess level of consciousness using GCS or AVPU ffPerform general (including ears) and neurological examination (pupils, motor and sensory examination, reflexes) –– Assess other possible trauma especially if road traffic accident, e.g., abdominal or chest trauma ffDO NOT SEDATE. Do NOT give opioids ffDo NOT give NSAIDs (risk of bleeding)}<b>Management of mild traumatic head injury</b><br>ffFirst aid if necessary ffMild analgesia if necessary e.g. paracetamol ffObserve for at least 4-6 hours, monitor GCS and neurological symptoms If low risk (see above) ffDischarge on paracetamol ffAdvise home observation and return to the facility in case of any change If high risk ffMonitor for 24 hours ffRefer immediately if GCS worsens or other clinical signs appear/persist ffIf patient is fine at the end of observation period, send home with instructions to come back in case of any problem (severe headache, seizures, alteration of consciousness, lethargy, change in behaviour etc.)}<b>Management of moderate traumatic head injury</b>ffRefer to hospital for appropriate management ffCareful positioning (head 300 up) ffUse fluids with caution ffKeep oxygen saturation >90% and systolic BP >90 mmHg ffMonitor GCS, pupils and neurological signs ffEarly CT if available, otherwise observe and refer immediately if not improving in the following hours}<b>Management of severe traumatic head injury</b><br>ffRefer immediately for specialist management ffSupportive care as per moderate head injury ffIf open head injury, give first dose of antibiotic prereferral –– Ceftriaxone 2 g IV Child: 100 mg/kg