Short case #4 for the Final FRCA
You are sitting in the theatre coffee room having nailed a popliteal block in front of your previously stand-offish educational supervisor who now thinks you're a total hero, when your bleep fires a trauma call alert to anyone who will listen.
A 32 year old woman is brought into the Emergency Department by ambulance after a road traffic collision.
While riding her bicycle at approximately 12 mph she was knocked over by a car pulling out of a T-junction. She was wearing a helmet and does not think she hit her head or lost consciousness.
Her left arm appears to have a second elbow halfway along the forearm.
Explain how you would approach this scenario
This is major trauma, which has a standardised ATLS primary survey approach.
- Catastrophic haemorrhage
- Airway with cervical spine precautions
- Breathing
- Circulation
- Disability
- Exposure
The aim is to identify and treat the most immediately life threatening injuries in order of importance, and not be distracted by other injuries.
For a head injury you're particularly interested in:
- GCS
- Pupils
- Evidence of skull base fracture
- Focal neurological deficits