Multiple injuries, hit by car part 2

Treatment

• Modified C-spine C-collar only on scene. Patient was moving head a lot and had a hard time following directions, kept looking all around using neck.
• En route – IV 20g L AC, vitals, EKG, VS

Disposition

• Hospital outcome – not known. CT scan, unk further.

Authors:

• Elliot Williams, Paramedic Woodburn Ambulance

Editors:

• Melisa McNeil, EMT WCU

Diagnosis

• MVC

Differential Diagnosis

• Laceration
• Hematoma
• Abrasion
• Fracture
• Subarachnoid hemorrhage
• Other traumatic injury

Patient Workup History

• Patient found seated on curb with hematoma on head, abrasion to right side of face, right forearm and wrist as pictured.
• Patient was crossing the road and hit by newer Cadillac sedan. • Denies loss of consciousness, states no neck or back pain.
• Chief complaint is forearm abrasion.
• Patient has been drinking tonight, odor on breath but unknown how much or what.

Physical Exam

• Otherwise unremarkable (R arm and head are only injuries).
• Patient is Spanish-speaking only, all information including consent done through translator.
• Clear lungs
• EKG NSR, CBG not done
• GCS 15

Editor’s Notes

As an EMS educator, after having students review this case, I would discuss kinetics, injury patterns, concerns surrounding consent, and associated complications (such as subarachnoid hemorrhage).

-Melisa McNeil, M.H.S., EMT-P; Residential Program Director of the Emergency Medical Care Program at Western Carolina University

Patient

• Gender: Male
• Age: 41 years
• Height: Not Available Vitals
• Temperature: Not Available
• Blood Pressure: 144/93
• Heart Rate: 110
• Respiratory Rate: 16
• Pulse Oximetry: Not Available