You are working as the UH-doc. Driving into your shift with the windows down and music playing, you figured the first warm day of the year would result in a busy day for you and the rest of the Air Care 1 crew. You arrive for your shift, grabbing the radio from the Pod doc when the tones go off for your first flight of the day. You grab the blood cooler head to helipad, checking your pager you find you’ll be responding to Southeastern Indiana for a “MVC rollover, entraped.”

You strap into the helicopter and fly over the city and to the rolling hills of Southeastern Indiana. Landing on the 4 lane divided state road, you unstrap and head to your patient who is waiting with the BLS squad.

You open the side door of the EMS truck and head to the head of the bed to assess your patient...

Your patient is a 35 year-old male with no known medical history who was the driver in a single vehicle MVC in rural Indiana. Per EMS, patient was seen driving at ~60mph when he hit a tree and rolled his vehicle two times into a ditch. Patient was found entrapped in the vehicle upon arrival of EMS. After approximately 15 minutes they were able to extricate the patient from the wrecked car.

Physical Exam

Vitals: P: 115, BP: 80/40, RR: 28, O2 Sat: 89% on BVM

General: in acute distress, multiple abrasions and contusions, in back of ambulance, smells of EtOH

Cardiovascular: tachycardic

Pulmonary: Decreased BS on the right, crepitus over right chest wall

Abdomen: +Seatbelt sign, tenderness to palpation diffusely

Musculoskeletal: deformity to right femur, no other obvious deformities, pelvis without obvious instability

Neurologic: moaning incomprehensibly, opens eyes to painful stimuli, withdraws to pain

Interventions PTA