Question

You and your partner respond to a 22-year-old male who has been in a motorcycle accident. He is unresponsive has shallow breathing and snoring respirations, bi-lateral mid-shaft femur fractures and is bleeding profusely from an open tibia fracture on his right leg. To manage this patient appropriately you should: - Select all that apply

a. Provide oxygen with a NRB at 15 LPM
b. Apply a traction splint to the left leg
c. Inset an OPA
d. Artificially ventilate
e. Control external bleeding

Answer 1

Appropriate management for a patient in this condition includes providing oxygen with an NRB at 15 LPM, potentially inserting an OPA, considering artificial ventilation if necessary, and controlling external bleeding with direct pressure or a tourniquet.

Step-by-step explanation:

In the scenario where a 22-year-old male has been in a motorcycle accident and is exhibiting shallow, snoring respirations along with bilateral femur fractures and a profusely bleeding open tibia fracture, appropriate management should include the following steps:

Provide oxygen with a Non-Rebreather Mask (NRB) at 15 LPM to ensure the patient receives enough oxygen due to shallow breathing.

Do not apply a traction splint to the left leg if it is not indicated (it should only be applied to the leg with the suspected femur fracture after assessment and following proper protocols).

Insert an Oropharyngeal Airway (OPA) if the patient is unresponsive with no gag reflex, to secure the airway and manage the snoring respirations.

Artificially ventilate the patient if needed, when their breathing is insufficient for maintaining adequate oxygenation.

Control external bleeding by applying direct pressure, using a tourniquet, or employing other hemostatic measures to manage the bleeding from the tibia fracture effectively.

Answer 2

To manage the patient properly, oxygen should be provided with a NRB at 15 LPM, an OPA should be inserted for airway management, and external bleeding should be controlled swiftly. Traction splint application and artificial ventilation are considerations based on training and further assessment.

Step-by-step explanation:

In managing a 22-year-old male patient who has been in a motorcycle accident, is unresponsive has shallow breathing with snoring respirations, bilateral mid-shaft femur fractures, and is bleeding profusely from an open tibia fracture on the right leg, the following steps should be taken:

• Provide oxygen with a Non-Rebreather Mask (NRB) at 15 LPM to ensure the patient is receiving enough oxygen despite his shallow breathing.
• Insert an Oropharyngeal Airway (OPA) if the patient is unresponsive without a gag reflex, to manage his airway and deal with snoring respirations which are indicative of partial airway obstruction.
• Control external bleeding by applying direct pressure, and if available, using hemostatic agents or tourniquets to manage the profuse bleeding from the open tibia fracture. Quick control of bleeding is critical.
• Since the patient has bilateral femur fractures, a traction splint may be applied if trained and authorized to do so. It is typically applied to a single side at a time, and because there's no indication of which leg is worse, we cannot choose to apply it specifically to the left leg without further assessment.

Providing assisted ventilation (artificially ventilating) should be considered if the patient's own ventilatory effort is inadequate. However, as it's not specified in the question that the patient's breathing is insufficient (only that it is shallow), this measure may be reserved until further assessment confirms its necessity.