Karen and Mike were returning home from a party in the early hours of Sunday morning. They left the party at about midnight . They were riding Mike’s 500cc motorbike with Mike driving and Karen as passenger. Both had helmets on.
A passing motorist calls ‘000 ’ at 02h15 asking for an ambulance. He says: ‘…they are both lying on the ground. He is very still . She appears to be in terrible pain and can’t move .’ The location is approximately 20 km from Charters Towers on the Hughenden road.
The first ambulance arrives about 15 minutes after the 000 call, followed by a police car about 5 minutes later.
Triage decision who needs to be taken to hospital first?
Tutors please facilitate this discussion based on ‘ABCD’ findings. The finding of a fractured jaw should immediately raise suspicion of cervical spine fracture; L hypochondrial pain should raise possibility of ruptured spleen
Which hospital Charters Towers : on call GP; TTH : Trauma unit. What are the pros and cons of each? Tutors: remind students re ‘stay and play’/’scoop and run’ debate; concept of ‘The Golden Hour’.
The ambulance paramedic calls TTH ED and speaks to the on call consultant; the helicopter is dispatched to collect Karen-Ann to take her to TTH; the ambulance will transport Mike by road to TTH.
Pathology review of trauma, Tissue injury & Wound healing in skin & special tissues.
Chest injury – lung collapse, surgical emphysema,
Abdominal Trauma - Splenic rupture.
Pathology of Head Injury *
"People blame their circumstances for what they are. I don't believe in circumstances. The people who get on in the world are the people who get up and look for the circumstances they want, and if they can't find them, make them ….!" - George Bernard Shaw
Pathology of Bone Fracture & Healing Dr. Venkatesh M. Shashidhar Senior Lecturer & Head of Pathology
This is a photograph of the left calf showing 30° equinus deformity and severe scarring to the back of the lower leg. This was due to a severe soft tissue injury with ischaemia of the calf muscles and infection. Note the split skin grafting of the lesion.
Median nerve injuries lead to loss of wrist flexion strength, ulnar deviation of the wrist, loss of thumb opposition, and loss of finger flexion of the thumb, index and long finger interphalangeal joints. When making a fist, the ring and small fingers flex while the long and index tend to stay straight. In low median nerve injuries the fingers are still able to flex, but thumb opposition is often lost.
If there is any doubt as to whether the nerve will recover, one should await for evidence of possible recovery of the nearest muscle supplied below the lesion. This is the brachioradialis with radial nerve injuries in the mid shaft of the humerus. The rate of possible regeneration of the nerve is assessed at 1mm a day or 3 cm (1 inch) a month plus an extra month.
The Chest X-ray showed rupture of the left hemi-diaphragm with associated collapse of the left lung. The Chest X-ray showed rupture of the left hemi-diaphragm with associated collapse of the left lung.
22 Female Motorcycle accident internal fixation was used after the fracture was reduced, and a Rush nail was inserted up the fibula to maintain alignment. Debridement and split skin grafting done. Surprisingly recovery… as no major vascular or nerve damage.
The collar cuff is supporting a fracture of the shaft of the humerus. The only absolute indication for a collar cuff sling in upper limb injuries is in humeral shaft fractures. This is because the weight of the arm help reduce the fracture and helps hold the fracture in alignment.