Instructions
You are an intern in the emergency department. Dimitri Kalogeropoulos, 19, has just arrived by ambulance with neck pain after a dive into shallow water.
Assess and manage the patient using an A to E approach
Outline to the examiner:
- Your most likely diagnosis
- Next steps in management, including relevant investigations
- A nurse is at the bedside and will carry out your instructions; describe procedures rather than performing them
- You do not need to take a full history
- You do not need to summarise your findings
Ambulance handover
Dived at about 2.45 pm into water about 1 metre deep; talking at the scene. Collar and head blocks on; one 18-gauge cannula in the left forearm; 250 mL sodium chloride 0.9% given. Alcohol on his breath.
Observations on arrival
RR 24, SpO2 93% on room air, HR 46, BP 76/40, T 35.9. Estimated weight 75 kg.