Collision of a 19 year old boy with a car in Newcastle

Running head: CASE STUDY
CASE STUDY
Name of the Student
Name of the University
Author Note

CASE STUDY
1
PATIENT PRESENTATION
At around 9 PM, an 18 year old boy named Dan Jones having a probationary driving
license met with a motor vehicle collision on the road outside Newcastle. His car was hit by
another car at 80 km/hr in the front. The airbag of Dan’s car was deployed, and he was held
back by the seatbelt. When the ambulance arrived at the accident scene, the crew noted Dan’s
situation. Dan’s condition in the Glasgow Coma Scale reading showed 15, which depicts his
consciousness. His respiration rate (RR) was 24. Dan’s blood pressure (BP) was 110/80,
heart rate (HR) was 90, and peripheral capillary oxygen saturation (SpO2) was 96%. Apart
from this, Dan complained of a pain in his right chest during inhalation. He was then brought
to the Jong Hunter Hospital within 9.35 PM by the ambulance after applying a few
precautions to support him.
CUE COLLECTION
The current patient status was checked maintaining ABCDE Framework on reaching
the hospital at 9.35 PM are shown in the table below(Resuscitation Council, 2020):
CRITERIA FINDINGS NORMAL RANGE
Airway No noted obstruction or
presence of blood in the
airway
Breathing RR: 28-30; SpO2: 93%;
difficulty in deep breathing;
auscultation shows nil air
entry in the lower left base;
palpation results to dull
sound; moderate left
pneumothorax; large
haemothorax
RR: 12-25 (Cleveland Clinic,
2020); SpO2: <95%
(Durlinger et al., 2017)
Circulation HR: 125; BP: 90/60; T:
35.7°C; cool peripheries;
capillary refill: 3 seconds
HR: 60-100 (Mayo Clinic,
2020); BP: 120/80 (The
Heart Foundation, 2020); T:
35°C-37.2°C (Medlineplus,
2020) capillary refill: ≤2.7
seconds (King, Morton &
Mevan, 2014)

CASE STUDY
2
Disability BGL: 5.8 mmole/L; GCS:
14; chest pain; Weight: 85
kg
BGL: 4.0-7.8 mmole/L
(Diabetes Queensland, 2015);
GCS: >8(BrainLine, 2020);
Weight: 57-58 kg at the age
of 19-20 (Centers for Disease
Control and Prevention,
2020)
Exposure Fracture of the left fourth
to ninth ribs; flail chest
from fifth to the seventh
rib; sternum fractured
INFORMATION PROCESSING
Dan Jones is suffering from quite a few abnormal conditions which were borne after
the accident. The abnormal cues identified are crucialand need immediate attention so that his
health does not deteriorate further. According to the ABCDE approach, every nook of his
body was checked by the trauma team and conducted a thorough checkup to find out the
issues which need to be addressed (Smith & Bowden, 2017).Dan’s condition can be
summarized as the following.Dan’s airway was clear, and no obstructions were found that
might not allow him to breathe properly. The team identified a mark which stretched across
his right chest horizontally his lower abdomen and a few cut marks on his right shoulder and
chin. Then his breathing conditions were checked, which gave results, including his
respiration rate, which was 28-30, and his SpO2 was found to be 93%. A shortness of breath
was also observed, and he could not take any deep breathing and has chest pain as well. On
auscultating, no air entry was seen in the lower left base of the lung, and on palpation, a dull
sound was heard. Apart from this, after conducting mobile X-Ray, a moderate left
pneumothorax and a large haemothorax wereobserved. Dan’s circulation showed sinus
tachycardia,and thus, an elevated heart rate of 125 beats per minute and capillary refill took 3
seconds. His blood pressure was 90/60 mmHg. His body temperature was 35.7°C, and the
peripheries were cool. Blood glucose level was checked and found to be 5.8 mmol/L. The

CASE STUDY
3
summation of his health attributes in the Glasglow Coma Scale came out to be 14. The X-Ray
results also showed that his sternum was cracked, and fractures were observed from the
fourth left rib to the ninth rib.
Some attributes of Dan’s health are in the normal state. However, a few attributesof
Dan’s health are in serious condition. The abnormal cues include the respiration rate, heart
rate, blood pressure, capillary refill, which are found to be in a range that is much more than
the normal range. Apart from these health vitals, he is suffering from moderate left
pneumothorax and a large haemothorax. His left ribs from the fourth to the ninth is fractured,
his chest is injured from the fifth to seventh rib, and his sternum is also broken.
There arequite a few evidence that individualsmet with motor vehicle injury leads to
symptoms like elevated blood pressure, heart rate, and respiration rate, and they also have a
higher mortality rate (Bhandarkar et al., 2017). The other critical conditions Dan is having
include pneumothorax, haemothorax, flail chest, and sternum fracture.
Pneumothorax is a phenomenon where the pleural cavity around the lungs gets
connected with the pulmonary alveoli, and the inhaled air gets transferred from the alveoli to
the pleural cavity creating an equilibrium destroying the normal state where there is a
pressure difference. This condition decreases the capacity of the pulmonary alveoli by about
33%. The air which enters the pleural cavity makes way for itself by compressing the lungs
by 25%. This change in pressure elevates the volume of the thorax and alters the recoil
mechanism of the thoracic wall by creating a decrease in vital capacity by 8%. As the
pressure exerted on the pleural cavity increases gradually, the thorax of that side expands and
thus, the diaphragm gets much more depressed than the normal state (Choi, 2014).
Hemothorax is the condition in which blood gets accumulated in the pleural cavity. It
causes pain in the chest which ultimately leads to breathing problem and also increases the