ECG of the Week - 20th February 2017

The following ECG is from a 20 yr old male who was brought to the Emergency Department following a motorbike accident in which he sustained a head injury. 
He has a GCS of 3, BP 160 systolic and divergent pupils.

Click to enlarge

Things to think about

• What are the key ECG features ?
• What are the potential causes for these changes ?