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Case 8 

Case 8
Chapter:
Case 8
Author(s):

Harutomo Hasegawa

, Matthew Crocker

, and Pawan Singh Minhas

DOI:
10.1093/med/9780199599837.003.0008
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date: 22 August 2019

A 32-year-old man is admitted to the emergency department following a car accident. He was the unrestrained front-seat passenger in a car which hit a tree at around 50mph. The driver was declared dead at the scene. The patient was attended by the helicopter service but transported 5 miles to the hospital by ambulance. At the scene he was maintaining his own airway with oxygen saturations of 93% on 15L of supplementary oxygen via face mask. He had bilateral air entry in his chest with evidence of severe bruising to the chest wall anteriorly. His pulse was 110bpm and blood pressure was 100/62mmHg. He was localizing with both arms and making occasional words but only opening his eyes to painful stimulus. He appeared to be in severe discomfort when being moved onto the stretcher, and pressure on his anterior superior iliac spines caused him severe pain.

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