Vikki, thanks for all your contributions to the list. Good luck with the USS
training.
We had 5 virtually simultaneous (few minutes apart) sick multitrauma
patients last night from the same head on collision. One of the interesting
challenges was imaging priorities.
1. 30 yr M, open head injury, combative, GCS E3V4M5, compound right knee
injury. Large heart on CXR ++
2. 65 yr G, Abdo pain, hypotensive on scene then sys ~ 90 in ED, wobbly
humeral fracture with cold hand and absent radial pulse
3. 62 yr F, flail chest, resps 40, shocked sys BP 75, pelvic butterfly #,
bilateral distal femoral shaft #s, one compound, conscious but non-english
speaking, sternotomy scar
4. 55 yr F, ABC okay, compound left knee injury, closed right ankle #
5. 12 yr F, vitals okay, pain on inspiration, extensive seatbelt bruising to
chest, severe seatbelt abrasions over her (tender) pelvis, tingling in
fingers (no neck pain). some ? pulm contusion on CXR.
CXR/PXR okay unless otherwise stated. No adequate lateral c spines achieved
despite arm pulls (local policy to take them, not my preference).
Any thoughts? - you've got one CT scanner running. There's an USS machine
available if you know how to use it. One radiology reg on his way in ......
and Vikki hasn't finished her sonography training (anyway it's Sunday
night!)
Cliff (wishing he hadn't remarked how quiet things were for a Sunday)
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