Patient: 37-year-old male
Incident: Pedestrian struck by SUV at 25 mph
Date/Time: December 19, 03:15
Location: Ina Garten's house in East Hampton

Assessment
Upon arrival, the patient was found conscious, coherent, extremely entitled, and annoyingly agitated, exhibiting significant pain in the chest and flanks, Vital Signs: Heart rate 135 bpm, Blood pressure 88/60 mmHg, Respiratory rate 43 BPM. Due to apparent respiratory distress, the patient is on a 100% nonrebreather mask.

Physical Exam
Airways are open and intact with no signs of obstruction; no lacerations or bleeding was observed anywhere on his body. There is notable edema and bruising on the entire thoracic area, with asymmetrical chest rise—the right side is non-compliant while the left rises typically. No breath sounds on the right lung filed with auscultation, but a sucking sound indicative of possible penetrating pneumothorax was detected. Crepitus is present, suggesting rib fractures. No head or neck injuries are visible.

Intervention
Administered supplemental oxygen and monitored vital signs closely. IV access was established for potential fluid resuscitation. The patient is prepared for rapid transport to the Sydney Pollock Hospital Emergency Department.

Impression
High suspicion of rib fractures, pneumothorax, and possible hemothorax. Continuous monitoring. Glasgow Coma Scale is 13, indicating mild to moderate head injury risk or hypoxia.

Transport

Transport is underway