Perform rapid assessment, including:
Glasgow Coma Scale score adapted to age
pupil size and reactivity to light
tone, reflex and movement of all four limbs
fontanelle (infants)
signs of basal skull fracture: Periorbital ecchymosis (‘raccoon eyes’), ecchymosis over the mastoid bone (Battle’s sign), obvious leakage of CSF from the nose or ears, hemotympanum. If one or more of these signs is present, no tube should be placed by the nasal route