Recent advances in the diagnosis of Kawasaki disease

Afour-year-old female, who was a lap belt restrained, back-seat-passenger involved in a motor vehicle collision, presents with head pain and right thigh pain. The car she was in hit the guardrail with a frontal impact at 70 mph. The child lost consciousness momentarily. Initial vital signs included a blood pressure of 100/62 mmHg, a heart rate of 136/minute, and a respiratory rate of 36/minute. The only abnormalities on examination included a left parietal contusion and deformity to her right femur. A large-bore intravenous catheter was initiated and 20 mL/kg of 0.9% normal saline solution was administered as she was transported to your emergency department. Your abdominal evaluation revealed a seat-belt contusion with a soft and nontender abdomen.What are the priorities in the initial evaluation and management of this child? How do you evaluate the potential intra-abdominal injuries?