A 20-year-old male presents following a bicycle accident. He is confused and has a large laceration on his scalp. His Glasgow Coma Scale score is 13. What are the potential diagnoses, and what are the next steps?
This patient's history of trauma, altered mental status, and scalp laceration suggest a significant head injury, possibly involving traumatic brain injury or skull fracture. A non-contrast CT scan of the head should be ordered immediately to assess for these injuries. The patient's scalp laceration will also need to be cleaned and sutured, and tetanus prophylaxis should be considered.