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External exam
Trauma
Motor vehicle accident
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1. Inventory the trauma.
2. Was the patient wearing a seat belt?
3. What areas of the body did the seat belt restrain?
4. If the patient was wearing a lap belt, how do you account for the difference in markings medially vs. laterally in the lower abdomen?
5. Is there any evidence of medical treatment?
6. Is the patient embalmed? How can you tell?
7. What evidence is there of decomposition?
8. Compare any contusions to any imprint/abrasion markings? What’s the correlation?
9. Based on the physical exam, what kind of internal injury might you expect? Specify which organs, structures, or regions.
10. How fast do you think the vehicle was going?
11. You are an emergency service provider. Imagine the body, before embalming with fresh marking. The patient is unresponsive. What is your first step?
12. The video does not show the head. Revise your answer to 11 presuming no external evidence of head injury.
13. The video does not show the head. Revise your answer to 11 presuming a head injury with contusions and lacerations but no obvious fracture.
14. The video does not show the head. Revise your answer to 11 presuming injuries to the front and back of the head.
15. You are an emergency service provider. In this case, the three other passengers appear unharmed. They are teenagers. There is no adult at the scene. How does this affect your plan upon arrival?
16. Revise your answer to 15 presuming you arrive and find 4 critically injured or unresponsive teenagers at the scene.
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