Question

Your patient is the 23-year-old female victim of an attempted abduction at knifepoint. The assailant was interrupted and drew his knife across the victim's throat as he fled the scene. A first responder on the scene immediately applied direct pressure to the neck wound. Your assessment reveals a very agitated young woman with ongoing blood loss despite direct pressure to the wound. There appears to be both bright-red bleeding and slower but steady dark-red bleeding. It appears that the trachea has not been penetrated but that there is a hematoma around the laceration. Which of the following is the most appropriate sequence of intervention for this patient?

A) Apply a pressure dressing to the wound, accompanied by pressure-point compression.
B) Use rapid sequence intubation of the patient to protect the trachea from the expanding hematoma while maintaining direct pressure on the wound.
C) Apply an occlusive dressing to the wound, and continue direct pressure.
D) Apply direct pressure, and request an order from medical control to decompress the hematoma.

Answer 1

The most appropriate sequence of intervention for the patient is to apply an occlusive dressing to the wound and continue direct pressure.

Step-by-step explanation:

The most appropriate sequence of intervention for this patient would be option C) Apply an occlusive dressing to the wound, and continue direct pressure.

In this scenario, the patient is experiencing ongoing bleeding despite direct pressure to the wound. The presence of bright-red bleeding and slower but steady dark-red bleeding suggests that the trachea has not been penetrated but there is a hematoma around the laceration.

Applying an occlusive dressing (such as a sterile, airtight dressing) to the wound can help seal off the area and prevent further bleeding. Continuing direct pressure on the wound can also help control bleeding until medical care arrives.