MVA – Car vs Tree
It is 12:05 am on a dark rural road after a night of heavy rainfall. You and your paramedic colleague are dispatched to a Motor Vehicle Accident (MVA) with a reported frontal impact into a large tree. The scene is a 10-minute response time from your location, and the nearest trauma hospital is 40 minutes away. Two police units arrive on the scene 2 minutes after you. The vehicle has sustained major frontal damage, with airbags deployed. On approaching the scene, you note two adult occupants in the front seats. The female passenger on the left side has no signs of life,
with a large tree branch impaled through her left upper chest and shoulder, indicating injuries incompatible with life. The male driver is slumped forward in his seat, unresponsive to painful stimuli, and making slow snoring sounds. His breathing is bradypnea at 8 breaths per minute, and his airway does not appear patent.
There is no visible significant external blood loss, but his skin feels cool to touch. He has no radial pulses bilaterally, a weak carotid pulse at 68bpm, and his SpO2 is unrecordable. Police have crowbarred open the driver’s door to assist you with access. Fire and Rescue are 15 minutes away, and the Critical Response Unit is unavailable, located at the trauma hospital.
Vital signs:
- GCS: 3 (E1/V1/M1)
- SpO2: Unrecordable
- Heart Rate: 68 bpm (weak carotid pulse, no radial pulses)
- Respiratory Rate: 8/min (snoring)
What hazards and risks are associated with this scene for you and your colleague and outline your initial plan and management using the information provided
Would you remove the driver from the vehicle before Fire and Rescue arrive, and what clinical interventions and pharmacology would you provide for this patient – provide a rationale for your answers
Assessment Criteria
The assessment will be assessed according to the following criteria:
- Q1: Demonstrates a good appreciation for the hazards and risk mitigations at the above trauma scene, in addition to providing a succinct plan with clear objectives for your trauma care pathway .
- Q2: Provides an evidenced-based rationale for extrication, and clinical decision-making, to support optimal trauma outcomes
- Quality of academic writing and presentation (e.g. spelling, grammar, punctuation, and presentation) .