Medical Emergencies · single question
A 13-year-old male was hit in the face during a soccer game. He has a headache and is bleeding from the gingival margin of teeth 9 and 10. What is the most appropriate FIRST step in managing this patient?
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Correct answer: D. Neurologic exam
With a history of head trauma AND a headache, a neurologic exam must be performed before any dental evaluation. The headache raises concern for concussion or intracranial injury, which takes priority over dental assessment. Radiographs and pulp tests come later once life-threatening conditions are excluded.
- A. INCORRECT. A cold test evaluates pulp vitality and is relevant to dental follow-up, but this is not the first priority when a patient reports a headache after head trauma.
- B. INCORRECT. Percussion tests assess periapical status — also important in dental follow-up but not the first step here.
- C. INCORRECT. Radiographic exam is valuable for detecting root fractures and alveolar bone injury but is performed after ensuring the patient is neurologically stable.
- D. CORRECT. The presence of a headache after facial trauma is a red flag for concussion or more serious intracranial pathology. A neurologic exam must be the first priority before any dental procedures.
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