firedoc5 Posted August 29, 2008 Share Posted August 29, 2008 Responded to MVA. Upon arriving you noticed the car struck a guard rail. Impact was on driver's side, not head on. Air bag did deploy. No side air bag. Driver is a 26 yr. old female. Passenger also young female and three kids in the back ages 8-12 yrs. old. They were coming back from the beach. Driver is the only one with any complaint. All others denied injury. Driver's c/c of both forearms burning and chest pain. Chest pain is sternal, but also complained that her left breast was also hurting. She is "well developed" (about a 34 D). Notice a fine white powder on forearms, hands, and bare legs. Probably from airbag. Complained of some shortness of breath, but appears to possibly be hyperventilating from anxiety, very worried about the kids. More to follow. Link to comment Share on other sites More sharing options...
Arizonaffcep Posted August 30, 2008 Share Posted August 30, 2008 Most important inital question, is the vehicle stable to work around? Or do we need to either shore it up, or get FD to shore it up? Link to comment Share on other sites More sharing options...
firedoc5 Posted August 30, 2008 Author Share Posted August 30, 2008 Car is stable, still on road way and traffic controlled. The road is a long sweeping curve. The driver was driving too fast around the curve causing her to lose control striking the guard rail. We responded to that stretch of road many times. Link to comment Share on other sites More sharing options...
AnthonyM83 Posted September 8, 2008 Share Posted September 8, 2008 What does the damage to the guard rail (what's it made of) and to the car look like? Any PSI? Where were the kids seated? Belted? Airbag deployment? For driver: Loss of consciousness? Seatbelt? Steering wheel airbag only? Speed they hit at? Angle of impact(full broadside with rail or more like scraped it with front left of car, or hit it head on more?) How exactly was she holding the steering wheel at impact? Does O2 alleviate the SOB? Does she start calming down after awhile? Lung sounds? Pulse, skin signs, and physical exam of areas hurting? (bruising, function ability, etc) Hx, Allergies, Rx? Link to comment Share on other sites More sharing options...
brentoli Posted September 8, 2008 Share Posted September 8, 2008 I'll hit my self in the head when you answer, whats PSI? Link to comment Share on other sites More sharing options...
AnthonyM83 Posted September 8, 2008 Share Posted September 8, 2008 Passenger Space Intrusion . . . they never used either the term or acronym in my actual EMT class, but in the field we check for it every TC b/c if it's present, we go to trauma center. Link to comment Share on other sites More sharing options...
brentoli Posted September 8, 2008 Share Posted September 8, 2008 Ok. Never thought of it being abbriviated, always just say "intrusion to passenger compartment." Back to Senario Link to comment Share on other sites More sharing options...
firedoc5 Posted September 8, 2008 Author Share Posted September 8, 2008 The curve is posted at 40 m.p.h. She may have been going 60. Seems like she started to skid then over corrected losing control. From the appearance to the left front and to the left side (driver's side), she hit the rail at the corner-point first then slid down the rail about 100'. Entire left side crinkled up with some of outer body stripped off. Major damage to left front. Guard rail was steel with wooden posts, didn't move much. Pt. was wearing seat belt, bruising noted to that effect. No LOC. Unknown grasp of wheel. Pt. did calm down after all passengers were removed from vehicle. All passengers were restrained properly. Skin color normal, moist (hot hot day), no immediate bruising to face. Pt. did state that prior to EMS on scene she had a very slight nose bleed which stopped after about a minute. Lung sounds clear bilaterally. Left side of chest and left breast hurt, described as a heavy feeling. Seat belt ran under her breast. Increased chest pain upon deep inhalation. Normal sounds when percussing. Upon palpating ribs increased pain mid-axillary approx. 5th-7th intercostal space(s). Patient was wearing shorts which were covered with white powder, evidently from air bag. Complained of upper legs "burning". Slight redness noticed, no bruising. Was able to move legs but complained of left knee pain, but was minor. Patient packaged per trauma protocols, c-collar with sand bags, full spine board. Pt. placed on 4L O2 per NC. O2 did not alleviate SOB which was now minor, or chest pain. Sand bag placed on pt. left side under arm. Once loaded exposed chest. Seat belt bruising noted. Slight redness (no abrasion) noted to upper left breast just below clavicle. Complained of most of breast hurting with increase of pain upon movement. Lung sounds remain good bilaterally. Link to comment Share on other sites More sharing options...
AnthonyM83 Posted September 9, 2008 Share Posted September 9, 2008 Sounds like seatbelt bruising or a rib fracture. Maybe rinse off her arms and legs to "stop the burn" if it's still actively bothering her. What was the sandbag on the left for? Immobilizing in case of possible rib fracture? Monitor EKG/O2Sat/VS Link to comment Share on other sites More sharing options...
firedoc5 Posted September 12, 2008 Author Share Posted September 12, 2008 Sounds like seatbelt bruising or a rib fracture. Maybe rinse off her arms and legs to "stop the burn" if it's still actively bothering her. What was the sandbag on the left for? Immobilizing in case of possible rib fracture? Monitor EKG/O2Sat/VS Exact reason for sandbag. Patient stated that slight pressure on her side helped relieve some pain. Monitor showed sinus tach @ 110. BP: 130/85 P: 100 reg. O2 Sat: 98%. Rinsed arms and legs thoroughly but still had burning sensation and redness becoming more prevalent. No hives. Patient did present slight orthropnea upon flat lay, but "not bad". Lung sounds remained clear bilaterally. Stated also upon flat lay that her left breast, when move upward caused more pain. No bruising or swelling noted to breast, just the redness as stated before. Since coming from the beach she was not wearing a bra, just a tube top. Also upon flat lay started to have upper lumbar pain described as an "burning ache". Link to comment Share on other sites More sharing options...
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