EMT Challenge Cases
CASE: LOSING MY HEAD
S: Robert is 32 years old. He was riding with his girlfriend (married woman he was having an affair with) in his sports car at a high rate of speed when he ran a red light and ran into the side of another car crossing the intersection. He was not wearing his seat belt and was thrown forward into the steering wheel amputating the woman's head in his lap. He suffered numerous lacerations and injuries to his head and was knocked unconscious. There appears to be some fractures to skull and face. He begins to wake after you arrive on the scene.
O: He responds to verbal commands to open his eyes or move his fingers after repeated commands and a short delay. There is a slow response to pain by withdrawing his arms. Blood pressure 100/60. Pulse 102. Breathing appears labored. Respiratory rate 28. Normal heart sounds. Pupils appear dilated, unequal, and are unreactive. Skin appears pale and moist.
How would you handle this patient?