Trauma Patient Case Study by

Traumatic Accident

kaylacarter12 — 2025-02-01 01:59:36 UTC

Jill and her friends were enjoying a hike up Mount Olympus Trail. This trail is located on the East bench up Big Cottonwood Canyon in Holladay. This trail is classified as hard and has some steeper areas. Jill and her friends weren’t quite to the saddle area, which is where the ground levels out before you make the ascent up the steep mountain side, where they were starting to slip off the mountain edge but were able to catch themselves before falling down the mountain. One of the slips Jill had she was unable to catch herself and fell down the mountain side. Jill suffered a head injury and she also has a compound fracture to the right arm. Jill is very altered but is conscious at the moment.

Where the trail head is located the hospitals that are close to the area are:

St Mark’s Hospital: Trauma Level II. 10-minute drive from the trailhead.

Intermountain Medical Center: Trauma Level I more specialized services offered. 12-minute drive from the trailhead.

Both of these hospitals offer the same level of care but Trauma Level II doesn’t have a research or resident programs, where Trauma Level I has this service.

EMS Response

2025-02-03 23:39:17 UTC

Initially I would prioritize locating and extracting Jill. Being at the saddle of the mountain they would likely not be able to escort Jill multiple miles back to the trailhead and would require a helicopter lift crew. When arriving on scene, I would ensure our own safety and find the best way to extract Jill, immediately focus on her ABC's and stablization of her of injuries. She is conscious but not oriented to situation and probably experienced a loss of consciousness. We are concerned about concussions, c-spine injuries/neurogenic shock, traumatic brain injuries, shock from increased intracranial pressure presenting in the form of Cushing's triad, and our most effective way of getting this patient to diffinitive care. We will also perform a full body assessment to idnetify any other bleeding, life threats, or injuries that the patient sustained. A focused neuro assessment reveals that she does not recall the incident, has 1 blown pupil, and is preogressively becoming more lethargic. She is curretly GCS 13. Her vital signs are HR 56, BP 165/81, RR irregular, and O2 91%. For treatment we will continue to reevaluate her airway in case her LOC changes and can no longer manage her secretions and oxygenate adequately. We will splint her right arm with the compound fracture and assess for adequate peripheral pulses, motor function, and sensation in that hand. We will establish 2 large bore and contact medical control if we can administer pain analgesia. We will also hang a little of fluid at TKO. We will avoid giving oxygen unless the patient desats below 90% and then prioritze immediate transport. I would fly this patient to the trauma level 1 hospital, IMC, and contact the hospital immediately after taking off to ensure that they are ready to recieve the patient. Vital signs will be monitored every 5 minutes and we will call report to the ER charge nurse.

Nurse:

kaylacarter12 — 2025-02-05 02:28:39 UTC

Thank you for the notification of patient.

Trauma 1 Activation:

Pt suffered a brain injury, has a compound fracture. Pt is in fight or flight response (mechanism of energy) which can lead to neurogenic shock, Cushing Triad, etc.

Members involved:

Trauma Doctor

Neurosurgeon called

Another nurse

Aide for supply runner

Lab

CT/MRI notified of Trauma Activation

Respiratory

House Supervisor

Supplies/Equipment:

Vitals

Cardiac monitor

IV Fluids

Respiratory intubation kit

Vent

Lab supplies

Hemorrhage supplies

Blood

EVD kit

Additional Information:

Updated GCS score

Updated vitals

Changes in neuro status

Updated respiratory status

Temperature outside at time of evac

EMS

alexblack5 — 2025-02-10 23:34:31 UTC

GCS score maintained at 13 during transport. Second set of vital signs after pain medications and fluid administration HR 60, BP 168/78, RR irregular still or at the rate of BVM, and O2 93%. No change in neurological status during transport and oxygenation status demonstrates no need for an advanced airway like ETT or iGel, potential for OPA/NPA if necessary. Core temperature of the patient is 36.4 with the temperature outside being 55 degress while hiking. Patient is trauma stripped but covered in warm blankets.