Case Study - Patient Profile D.F., a 20-yr-old Hispanic female trauma victim, is brought to the ED in an ambulance. She was the driver in a motor vehicle crash and was not wearing a seat belt. Two unrestrained children in the car were pronounced dead at the scene. The paramedics said there was significant damage to the car on the driver's side. Subjective Data • Patient asks, "What happened? Where am I?" • Reports of shortness of breath and leg pain Objective Data Physical Examination • Vital signs: BP = 85/40 mm Hg, HR = 140 beats/min, RR = 36 breaths/min; O2 saturation = 85% with 100% nonrebreather mask • Decreased breath sounds on left side of chest • Asymmetric chest wall movement • Glasgow Coma Score = 14; pupils slightly unequal • Badly deformed left lower leg with significant swelling and a pedal pulse by Doppler only • 4-cm head laceration, bleeding controlled Discussion Questions
1. What are D.F.'s most likely life-threatening injuries?
2. Priority Decision: What is the priority of care for D.F.?
3. Priority Decision: What interventions does this patient need immediately?
4. What other interventions should you consider?
5. Collaboration: What activities could you delegate to?