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Trauma Triage Scenario 4. Scenario 4. Scene Info. Car v. child on a sled Car was traveling 50 mph 5 y/o female patient (45 lbs) impacted the front bumper and was then run over by the car Witnesses lifted the car and removed the child. What does this information provide us?
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Scene Info • Car v. child on a sled • Car was traveling 50 mph • 5 y/o female patient (45 lbs) impacted the front bumper and was then run over by the car • Witnesses lifted the car and removed the child What does this information provide us? What additional information do you need?
Initial Assessment • Does not open eyes • Responds to pain with abnormal flexion • Non-verbal • Airway: moderate amount of bleeding, gurgling • RR=12, = Cx expansion, = lung sounds • Strong radial pulse of 70 • Skin pale, cool, moist Can you estimate GCS & Pedi RTS? What is the Patient Status?
Focused H&P • Head: Bleeding from ears, nose, and mouth • Pupils: ≠ and L. does not respond to light • Neck: No JVD, tracheal deviation, or C-spine deformity • Chest: No injuries noted, = Cx expansion, = lung sounds • Abdomen: soft • Pelvis: stable • Extremities: R. leg deformity and swelling to entire leg • Back: No injuries noted • Pulse 80, BP 90/50, RR 14 Confirm or dispute your initial severity determination.
Trauma Communications What pertinent information will you communicate to medical control?
Transport Decision • Injury Severity • Hospital capability, location, driving time due to traffic • Regional Level III Hospital is 10 minutes by ground • Regional Level I Hospital is 20 minutes by ground • ALS intercept is not available • Helicopter is available and ETA to scene is <10 minutes (responding from the Regional Level 1 Pediatric Hospital) What decision will Medical Control make and why?