Question

You are the first EMS Provider to arrive on the scene of a head-on automobile accident where you find the following:

Patient #1 appears to be intoxicated has pain in his right shoulder, and is belligerent toward the rescuers

Patient #2 also appears to be intoxicated and is very slow in responding to questions. He has burns on his lower legs and feet from the car heater and complains 0f a pain in his back

Patient #3 has an open wound to the brain, which is not bleeding, He has no pulse or respiration, and his chest pinned between the steering wheel and the seat

Patient #4 has a laceration across the abdomen that is bleeding profusely, and a portion of the colon is protruding

Which patient should be treated and transported FIRST?

a) Patient # 1
b) Patient #2
c) Patient #3
d) Patient #4

Answer 1

Patient #4 should be treated and transported first due to a profusely bleeding wound and protruding colon. Patient #3 is likely deceased, and Patients #1 and #2, while injured, are not in as critical a condition. O negative blood is used for transfusions when a patient's blood type is unknown.

Step-by-step explanation:

In the scenario presented, the choice of which patient should be treated and transported first follows the principles of triage, which prioritize patients based on the severity of their conditions and the potential to save lives. Patient #4 should be treated and transported first because they have a laceration across the abdomen that is bleeding profusely, and a portion of the colon is protruding, indicating a life-threatening situation that requires immediate medical attention to prevent exsanguination.

Patient #3, who has an open wound to the brain, no pulse or respiration, and their chest pinned between the steering wheel and the seat, is likely deceased and cannot be saved, hence does not take precedence over other patients with life-threatening injuries that can still be treated. Patient #1 and Patient #2 seem to be stable, despite being intoxicated, and their injuries, although serious, do not appear to be as immediately life-threatening as those of Patient #4.

In cases of severe bleeding where there is no time to determine the patient's blood type, O negative blood is usually transfused because it is the universal donor type and can be accepted by patients of any blood type, minimizing the risk of transfusion reactions.