Situation 2: You respond to a report

Situation 2: You respond to a report of a motor vehicle collision. The patient is an 82-year-old male who appears to have lost control of his car, which struck a utility pole. The patient is awake, alert, restless, and anxious. Respirations are rapid and shallow at 24 breaths/minute. Radial pulses are weak at 80 beats/minute. The patient’s blood pressure is 128/86. The left lower chest is bruised and is tender to palpation. The left upper abdominal quadrant is tender. Breath sounds are present and equal bilaterally. The patient also complains of pain in his left shoulder. However, there is no bruising, tenderness, or deformity of this area. The patient takes a “blood pressure pill,” but he cannot remember its name and does not have the bottle with him. On the basis of the evidence, what problem do you believe this patient is having? Why? What other problems might he be having? What other questions might help you in your diagnosis? What treatment should be given to this patient? Why might the patient’s heart rate be especially important in this case?

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