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A 7-year-old boy presented with neck (fig 1A), chest and abdominal contusions following a frontal impact motor-vehicle accident. He had severe dyspnoea with cyanosis, recessions, hoarseness, deep stridor and haemoptysis. Diffuse crepitus and oedema with neck asymmetry were also noted. On impact, the patient was restrained by a three-point belt system, …
Competing interests: None.