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e-CASES: Polytrauma severe cranial injury following road traffic accident

18-year old patient, severe cranial injury following road traffic accident: collision between scooter and light vehicle, front impact, expulsion of helmet during accident.

 

Initial clinical examination:
- Glasgow = 7 at start of care, deviation of eyes to right, reactive, symmetric pupils.- Reduction in normal breath sounds over right pulmonary field,- Stable hemodynamics, blood pressure: 130/70 mmHg, heart rate: 69, oxygen saturation: 100%,- Soft, painless abdomen.
After intubation, degradation of hemodynamics, requiring massive intravenous fluid therapy.On the arrival of the emergency services, blood pressure: 80/40 mmHg, heart rate: 65, oxygen saturation: 100%. Instigation of Norepinephrine treatment for hemodynamic support and transfer to university hospital after intravenous administration of 2 l of colloids and 1.5 l of crystalloids.

 

The body scan is provided.