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Fri Dec 10 10:39:28 GMT 2004

We managed a similar singular episode of sudden LOC followed by a rapid
return to a full lucid state by a gentleman in his 50's who had been working
in his loft and as he came down the ladder lost footing and banged his head
on loft hatch entrance.

Presenting Hx Headache and more concerning to pt "Pins n needles in left
arm"
	        GCS 15/15

Nurse turned to get some analgesia for headache turned back to find pt
slumped on trolley, call for MET. Upon team arrival GCS 3/15 and preparing
to tube and ventilate then trip to the donut and probably ITU if not a
definitive Neuro Centre. Drawn up RSI drugs preparing tube and hey presto
back with us 14/15. Took pt to CT anyway (conscious) but with all kit just
in case! CT showed nothing of significance and pt admitted for 48 hrs
observation with no further episodes.

Gavin Turner RODP
Eastbourne DGH UK

-----Original Message-----
From: trauma-list-bounces at trauma.org
[mailto:trauma-list-bounces at trauma.org]On Behalf Of Jason Cabral
Sent: 09 December 2004 15:24
To: Trauma & Critical Care mailing list
Subject: silly question

46 YOF involved in medium speed vehicle rollover.  Upon arrival, found
vehicle approx. 200 feet down the embankment on it's lid with moderate
compartment intrusion.  Woman found under bushes complaining initially of
severe back pain prior to becoming unresponsive.  2-3 minutes later, pt is
all of a sudden totally lucid, answering questions appropriately, full
recolection of the incident.  approx. 2 mins later, patient is unresponsive
once again.

We repeated this cycle for the entire time i was with her with no
lengthening of time periods between each other.

This patient admitted to have been drinking that AM (this was about 1115)
and was the passenger of a full sized pickup.  Pt stated that she was
restrained, but had been ejected about 50-75 feet from the vehicle.  Patient
also weighed about 350 lbs.  She presented with your typical scrapes and
bruises, the back pain, and progressively worstening bruising throughout her
ABD.  She was flown to the nearest trauma center, and the only follow up
information i was able to obtain is that she probably died, but nobody would
tell me for sure.

My questions are these:

I have never seen an ALOC of that nature.  Is that indicative of something
specific, was it the alcohol, was she probably faking, or maybe a
combination of all three?

Is a person with an abdomen as large as hers that is showing bruising
already bleeding out faster that someone of a more average stature?  What
are her odds with an extended scene time due to extrication and about a 30
minute helicopter ride?

Thanks for the time, and sorry for the silly questions

Jason Cabral

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silly question