Trauma Case Study

High-Speed Motor Vehicle Collision

15-20 minutes

Advanced Level

3 Questions

Case Presentation

Dispatch Information

You respond to a high-speed motor vehicle collision on the highway. The patient was the unrestrained driver who struck a concrete barrier at approximately 65 mph. The airbag deployed. The patient is conscious but confused.

Patient Information

Age: 28 years

Gender: male

Weight: 80 kg

Chief Complaint: Multiple trauma from MVC

Vital Signs

BP: 92/58 mmHg

HR: 128 bpm

RR: 28/min

SpO2: 91% on room air

GCS: 13/15

Physical Examination

General: Alert but confused male in obvious distress

HEENT: Forehead laceration 4cm, bleeding controlled. No obvious skull deformity

Chest: Decreased breath sounds on left side, paradoxical chest movement noted

Abdomen: Tender in LUQ, positive seatbelt sign across abdomen

Extremities: Obvious deformity to left femur, pedal pulses present bilaterally

Question 1 of 3

10 points

Based on the mechanism of injury and initial assessment, what is your primary concern?

Critical Interventions

High-flow oxygen via non-rebreather mask

Apply 15L/min O2 via NRB mask

immediate

Cervical spine immobilization

Apply cervical collar and maintain spinal precautions

immediate

IV access and fluid resuscitation

Establish 2 large-bore IVs and begin warm crystalloid infusion

immediate

Splint femur fracture

Apply traction splint to left femur

urgent

Clinical Pearls

•Hypotension + Trauma = Hemorrhage until proven otherwise
•High-energy mechanism predicts serious injuries
•Load and go for unstable trauma patients