Instructions
You are an intern in a regional emergency department in the Wheatbelt. Andreas Kostas, 52, a farmer, has just arrived by ambulance. Two hours ago his quad bike rolled and landed across his lower body; his son found him pinned under it an hour later. He is pale, with pain low in his belly and hips.
Assess and manage the patient using an A to E approach
Outline to the examiner:
- Your most likely diagnosis
- Next steps in management
- A nurse is at the bedside and will carry out your instructions; describe procedures rather than doing them
- You do not need to take a full history
- You do not need to summarise your findings
Observations on arrival
RR 26, SpO2 97% on 15 L via non-rebreather mask, HR 128, BP 82/50, T 35.3; estimated weight 92 kg. The ambulance crew have put in one cannula.