This has lead to substantial loss: (blood soaked clothing)

compensation for blood loss is evident: increase in heart rate and increase in breathing rate

possible hypovolaemic shock=>"non-progressive"=>signs of compensation in the face of hypotension.

Heightened SNS: increased heart rate, pale (reduced peripheral circulation due to increase vasoconstriction) anxious (increase in stress response hormones).

other scanning modalities: CT scan whole bodys can

Fluid resuscitation

Bloods: full blood and blood gases

oximetry

UEC (elevated sodium?)

Blood typing

wound debriding?

pain relief

(prophylaxis infection?

skin examination for trauma)

Neurological assessment and obs

Bracing if evidence of any bruising to head or neck

nil by mouth

prolonged lack of vitamin D and possibly calcium from lack of nutritious diet --> results in abnormal osteoid mineralisation. Bone resorption as a result of increased osteoclast activity.

weakened bones cause partial fractures --> evident by his uncomfortable walking and complaints of pain.

lack of exercise also contributes to bone mass loss --> resulting in weakened musculoskeletal system.

tenderness in ribs is also an indicator of osteomalacia and that it could potentially be starting to affect other regions of the body.

background is Srilankan, (most likely darker skin) --> needing more vitamin D intake, however since lack of vitamin D, disease progressing at a faster rate.

increased weight --> puts more pressure on bones due to sedentary lifestyle, increases the progression of disease at a faster rate.