Multivictim trauma

Scenario overview A 48-year-old man with no PMH is brought in by the paramedics after a motor vehicle collision. The patient was a passenger using a seatbelt and with a child in the back seat (who also presents as a patient). The child is a 6-year-old boy with no significant medical problems. The car was “T-boned” on the driver's side. The other car's victims were taken to another hospital. There was airbag deployment and severe damage to the car. Both patients were non-ambulatory at the scene and had to be extricated from the vehicle; both are brought in as trauma activations, boarded and collared. The adult will ultimately be in hemorrhagic shock from an open-book pelvic fracture, and the child will be in spinal/neurogenic shock. Both patients will require early intervention and fluid resuscitation. There will also be a third patient who comes into the ED as a “walking wounded.” This patient will require the team to use appropriate triage techniques and medical stabilization. Teaching objectives/discussion points Clinical and medical management.