You respond on a motor vehicle collision -- rollover -- and are advised by the first responding fire units that the patient is ambulatory at the scene. You arrive shortly thereafter, and park in a safe location on the side of a interstate highway in your jurisdiction. Your single patient, a young 18 year old male, is walked over to you by the firefighters, and shows you a large deep laceration to the palm of his hand. There are tendons visible / exposed in the wound. He notes that he injured his hand on broken glass when climbing out of his mangled vehicle. It is not actively bleeding, and CMS is intact. The fire chief states that witnesses estimate the vehicle was moving at 65-70+mph when it left the highway. There was heavy damage to the front and rear of the vehicle and damage to the roof. All airbags deployed including side airbags. The patient states that he fell asleep while driving. He denies other injuries and denies neck pain. A quick head to toe survey shows no acute life threats and no other obvious injuries. Vitals: HR 98, BP 159/97, RR 18, SpO2 99% RA. As one of the firefighters walks a backboard over from your ambulance, the patient states, honestly Im fine -- nothing else hurts. I dont think you need to put that contraption on me. How would you proceed from here? Does this patient meet criteria for a backboard? Would you transport this patient 6 minutes by ground to the local community hospital, or 40 minutes by ground to the nearest trauma center? What other steps would you take in care?
Posted on: Tue, 19 Aug 2014 23:04:52 +0000
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