scenario017
35 year old internet entrepeneur jumps from a 3rd floor window and appears to have an isolated head injury.

Primary Survey

Airway: Intubated Breathing: Bilateral, equal air entry. No obvious external chest injuries. O2sats 96% on 60% oxygen. Ventilated. Circulation: Pulse 80/min, BP 160/100. Dysfunction: GCS 5(E1V1M3) prior to intubation. Pupils equal & reactive.

CT scan shows a large parietal contusion with some diffuse brain injury.

Arterial Blood Gases show: pH 7.38, PaO2 14kPa (105mmHg), PaCO2 5.8kPa (43.5mmHg), Base excess -2.8