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I would give hypertonic saline.
Mike F.

> On Aug 8, 2017, at 3:50 AM, Eran Kozer <[log in to unmask]> wrote:
> 
> A question for the group:
> A 15 y old boy arrived to the ED 20 minutes after falling from a ladder (approximately 2m height). There was no LOC. On arrival to the ED – GCS 15, normal vitals, no focal neurological signs (walking,  talking with the nurse). Large open depressed temporal skull fracture.  5 minutes after arrival – seizures, treated with midazolam, the seizures stopped, intubated (RSI).  HR 110, BP 130/80 pupils equal and reactive. 
> Would you treat with hypertonic saline/mannitol at this point?  (CT is immediately available for this patient)
> Thanks
> Eran
> 
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For more information, send mail to [log in to unmask] with the message: info PED-EM-L
The URL for the PED-EM-L Web Page is:
                 http://listserv.brown.edu/ped-em-l.html