boeingb13 Posted August 16, 2008 Share Posted August 16, 2008 You are called to the scene of a 49 y/o male He is on the ground unconsious, he is laying next to a large dumptruck, with a wrench a few feet from him, and the hood is up. He is bluish purple from the nipple line up He has no pulse, and no one saw what happened, they only guess he fell Upon opening his airway you find alot of blood and what appears to be a traumatic injury to the back of the throat, with the appearance of bloody hamburger meat. What is your assessment, what would you do, but the main thing im looking for, is why is this guys throat like this, what could it possibly be? This call threw us for a loop until someone told us something that made it make sense. After a couple responses i'll post the answer. Link to comment Share on other sites More sharing options...
mobey Posted August 16, 2008 Share Posted August 16, 2008 Is he dirty like he has been covered in gravel, traumatic asphyxiation? naa, probably not. Possibly working on a high pressure line - hydraulics, coolant, a/c, and had a piece of steel shoot into his open mouth. Is the bluish purple the skin color or a foreign fluid on the body? Link to comment Share on other sites More sharing options...
boeingb13 Posted August 17, 2008 Author Share Posted August 17, 2008 The bluish purple is the skin color, it is from the nipple line up. The ground is hard packed clay, no gravel or loose stones. I to racked my brain over what this could be, and now that I know I will never forget it, in case this ever comes up again, I will post what it is in 2 days. Link to comment Share on other sites More sharing options...
mobey Posted August 17, 2008 Share Posted August 17, 2008 Any burns around his mouth? Hair singed? Any vehicle parts around the body? This seems like oropharygeal trauma, although ruptured varicies crossed my mind, but I would expect a bloody mess down the front of the pt, and on the ground. Link to comment Share on other sites More sharing options...
boeingb13 Posted August 17, 2008 Author Share Posted August 17, 2008 No burns of any kind, other than the discoloration from the nipple line up, the pt is unremarkable. He's laying there, a wrench a few feet away, no one saw anything, they only assume he was working on the equipment and fell, if he fell the fall would of been 3 feet. But no one was around him all morning, except when he showed up. He made some coffee, grabbed his tools, threw in some chew and went into the field. Link to comment Share on other sites More sharing options...
mobey Posted August 17, 2008 Share Posted August 17, 2008 No burns of any kind, other than the discoloration from the nipple line up, the pt is unremarkable. He's laying there, a wrench a few feet away, no one saw anything, they only assume he was working on the equipment and fell, if he fell the fall would of been 3 feet. But no one was around him all morning, except when he showed up. He made some coffee, grabbed his tools, threw in some chew and went into the field. I am still tossing esophogeal varicies around, only because I don't know what they look like. Not too likely the wrench went in his mouth, but he may have removed a nut that was under pressure and caught it in the oropharynx. Link to comment Share on other sites More sharing options...
Kaisu Posted August 17, 2008 Share Posted August 17, 2008 The color change from the nipple line up indicates neurogenic shock.. I would immediately suspect spinal cord injury at the level of T4 - T5. Something caused serious injury to this man's spinal cord. What is happening in the throat is probably due to this trauma. Link to comment Share on other sites More sharing options...
DwayneEMTP Posted August 17, 2008 Share Posted August 17, 2008 Nipple line up is classic PE.... Any tissue/blood on the wrench? Dwayne Link to comment Share on other sites More sharing options...
Chief1C Posted August 17, 2008 Share Posted August 17, 2008 I've seen a few deceased MI victims that were blueish purple from the mid-trunk to the head, with pale lower extremities, bleeding from the mouth. Link to comment Share on other sites More sharing options...
defib_wizard Posted August 17, 2008 Share Posted August 17, 2008 could the "hamburger" be his chew? Link to comment Share on other sites More sharing options...
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