priaprism
Chest pain?
On January 14, 2013 a 28 year old unrestrained driver was driving down the road toward a huge 4 way intersection. He ran a red light and a truck was passing right in front of him. He t-boned a truck going 50 mph heavy front end damage and a 2 foot intrusion plus a 30 minute extrication with the jaws of life, c-spine immobilized, collar applied and we used a KED to remove the patient out safely and we question LOC. After he hit the truck negative airbags, the patient hit the steering column and has a very large contusion on his chest.
The patient after being extracted from the automobile and placed on backboard and was secured as we did a primary assessment. His airway was clear his breathing was labored and he has paradoxical chest movement. He is pail and moist, his pulse is thready times 4. Cap refill is longer than 5 seconds. Shoulder shrug noted the sensation to nipple line. Grip strength weak. When he is exposed he has a priapism present. His vitals are, BP is 90/60 heart rate is 60, respiration 24, GCS is 11; e3, m4, v4. His heart rate is slow because of presumed neurogenic shock. We placed him on 100% fio2 at 15 LPM by a NRB. We also got two large boar IVs, 2Liters of saline open wide, we load and go and as we are loading the patient into the bone box he vomits.
We suction his airway then we put him on a monitor we opted to RSI (rapid sequence intubation) and intubate with an 8mm ET tube. He begins to improve then all of a sudden his O2 saturation starts to drop I checked the ET tube placement and there was tracheal deviation to the left difficulty to ventilate. JVD (jugular venous distention) and BP is 85/55. Needle decompress the right chest. He begins to improve once again his o2 sat and BP begins to improve and we arrive to the trauma centre and report given to the trauma team.
Presumed injuries are head injury, spinal cord injury, broken ribs, and tention pneumo thorax.
On January 14, 2013 a 28 year old unrestrained driver was driving down the road toward a huge 4 way intersection. He ran a red light and a truck was passing right in front of him. He t-boned a truck going 50 mph heavy front end damage and a 2 foot intrusion plus a 30 minute extrication with the jaws of life, c-spine immobilized, collar applied and we used a KED to remove the patient out safely and we question LOC. After he hit the truck negative airbags, the patient hit the steering column and has a very large contusion on his chest.
The patient after being extracted from the automobile and placed on backboard and was secured as we did a primary assessment. His airway was clear his breathing was labored and he has paradoxical chest movement. He is pail and moist, his pulse is thready times 4. Cap refill is longer than 5 seconds. Shoulder shrug noted the sensation to nipple line. Grip strength weak. When he is exposed he has a priapism present. His vitals are, BP is 90/60 heart rate is 60, respiration 24, GCS is 11; e3, m4, v4. His heart rate is slow because of presumed neurogenic shock. We placed him on 100% fio2 at 15 LPM by a NRB. We also got two large boar IVs, 2Liters of saline open wide, we load and go and as we are loading the patient into the bone box he vomits.
We suction his airway then we put him on a monitor we opted to RSI (rapid sequence intubation) and intubate with an 8mm ET tube. He begins to improve then all of a sudden his O2 saturation starts to drop I checked the ET tube placement and there was tracheal deviation to the left difficulty to ventilate. JVD (jugular venous distention) and BP is 85/55. Needle decompress the right chest. He begins to improve once again his o2 sat and BP begins to improve and we arrive to the trauma centre and report given to the trauma team.
Presumed injuries are head injury, spinal cord injury, broken ribs, and tention pneumo thorax.