Chapter 12 Case Study: Complete scenario with answer
Based on the scene scale-up, it is possible that the patient sustained injuries from the deployment of an airbag or damage to his steering wheel. The patient’s general impression is pale.
Next, a thorough head-to-toe evaluation is required to assess this patient. This includes a physical exam to determine if there are any injuries. Given the extent of the vehicle damage, this is likely to cause serious injury.
There are concerns for the patient’s hemodynamic stability as evidenced by the vital sign changes, including an increased heart rate, respiratory rate, and clammy skin. The patient’s recent illness is significant because it may exacerbate the patient’s hemodynamic instability and increase the risk of infection.
These vital signs indicate shock. In particular, compensatory shock is when the body tries to keep blood pressure down while trying to perfuse vital organs.
For each of the palpable pulse locations, these are approximate systolic BP s values: radial (880 mm Hg), Carotid (60 mmHg), and Femoral (70 mmHg).
In this situation, the MOI is important. This MOI can cause injury to specific organs and structures, such as the abdomen, chest and head.
The patient’s recent history of strep throat is significant when evaluating the level and possible progression of shock because it may exacerbate the patient’s hemodynamic instability and increase the risk of infection.
As the patient may be in compensated shock, it is possible that the body is trying to preserve perfusion to vital organs even though blood volume has decreased. The increased heart rate and respiration rates are evidence of this.
Patients in severe shock may present with hypotension, tachycardia and tachypnea as well as altered mental state. You may notice clammy, cool skin or delayed capillary.