trauma significant mechanism of injury

example: toned for ejection from a vehicle during a rollover

BSI/ scene

we have been called for an ejection from a vehicle roll over

is this our only patinet

yes this is your only patient

we will call for air rescue/ ALS
you are at the patient: my partner will take c-spine

My general impression is a male approximately 20 year old, ejected from a vehicle during a roll over. we will have firefighters question the bystanders about what they witness
Sir, sir can you hear me?

your patient does not respond to verbal

im pinching the patient does he respond

no your patient is unconscious/unresponsive

are there obvious signs of life and are there any obvious life threats

yes, there are obvious signs of life, there are no obvious life threats

my partner opens the airway with a jaw thrust. is the airway patent,

yes the airway is patent

my partner will place an opa in the airway
im assessing her breathing. What is the rate rthem and quality

she’s breathing 30 times per min, regular rhythm and shallow quality

my partner will begin ventilating the patient with a bvm 100% oxygen at 1 every 5 seconds

im assessing the heart rate (carodid and radial) whats the rate, rhythm and quality of it.

the pulse is 110, regular and weak

im assesing the skin color, temperature and condition what is it

its pale cool and clammy

whats the spo2

her spo2 is92%

are there any bleeds

no there are no other bleeds

The patient is presenting with shock, well place a blanket on him

hhis gcs is3

he is a high priority patient

i will palpate, inspect and asustalte as i assess the patinet

checking for dcap btls/C/SFD/PMS

im inspecting the scalp what do i find

the scalp is negative for injuries

im inspecting and palpating the ears for drainage what do we have?

im inspecting and palpating the mouth,nose and facial area and checking for drainage what do we have
etc

all negative for injuries

im assessing the the eyes.pupils reaction and equal size what do we have

pupils are equal size and slow to react

im assessing the neck. checking for jvd, trachea deviation, and step offs. what do we have

The neck is negative for injuries,jugular veins are flat, indicated blood loss there are no step offs

My partner will place a c-collar on the patient now

We have removed the patient's clothing lmao im inspecting and Palpatine the patient's chest what do I find

There are paradoxical movement on the right rib area

Well stabilize the flail segment with bulky dressing

Im listening to lung sounds what do I hear

the lung sounds are diminished on the right side. bulky dressinghas stabalised the segemrnt

im palpating and inspecting the abdomen what do i find

there is rigidity in the upper quadrant. most likely a liver laceration

im palpating and inspecting the pelvic area. pushing down and squeezing inim checking the genital area what do we find

the pelvic ring is stable , no injuries noted genitalia is negative for injuries

im inspecting and palpating the right leg. checking for pulse. movement and sensation what do i find

minor abrasions and contusions there is a pulse ,no movment or sensation due to patinet’s unresponsiviness

im inspecting and palpating the left leg, checking for pulse. movement and sensation what do i find

minor abrasions and contusions there is a pulse ,no movment or sensation due to patinet’s unresponsiviness

im inpsecting and palpating the right arm, checking for pulse, movment and sensation and capillary refill what do i find

theres a deformity near the wrist . there is a pulse no movment or sensation due to patinets unresponsiveness cap refil is 2 seca

im inpsecting and palpating the left arm, checking for pulse, movment and sensation and capillary refill what do i find

minor abrasions, there is a pulse no movment or sensation due to patinets unresponsiveness

we are log rolling the patient im inspecting and palpating the back and down the legs what do i find

the back is negative for injuries

we will log roll him back onto the longboard. secure him, hips,nips and knees. head blocks on

we’ll load him onto the unit

my partner will take a set of vitals could i get those

pulse is 110 weak but regular. breathing is 30 and shallow ut being ventilatined at 1 every 5 seconds with 100% oxygen. blood pressure is 90 over 52. skin is pale cool and clammy cap refil is 2 secs and spo2 is 94

is there anyone to give a sample hisotry

no there is no one available at this time

Detailed assessment, always done en route to the hospital, always on the significant moi patient

detailed assessment 1

repeat primary and secondary assesment

detailed assessment 2

head/face/eyes/ears/nose/mouth

detailed assessment 3

neck(through c-collar hole)

detailed assessment 4

chest

detailed assessment 5

abdomen

detailed assessment 6

pelvis

detailed assessment 7

extremities

ongoing assessment

recheck all injuries from secondary exam

recheck all interventions

recheck any chnages

report to hospital