You are dispatched to a motor vehicle crash on a rural road where a single vehicle is up on an embankment. The vehicle has front-end damage and a starred windshield. The unrestrained driver is lying supine in the road; the police report that they found the patient outside of the vehicle. He is unconscious and has obvious facial bleeding. Examination reveals a hematoma and depression of the lefttemporal area, both eyes are black and blue, and one pupil is dilated, whereas the other is normal. The patient has blood coming from the nose and mouth, and palpation reveals subcutaneous emphysema around the clavicles and chest area. The patient’s breathing is labored, and the pulse is rapid and thready.The unequal pupils most likely indicate what type of injury?

You are dispatched to a motor vehicle crash on a rural road where a single vehicle is up on an embankment. The vehicle has front-end damage and a starred windshield. The unrestrained driver is lying supine in the road; the police report that they found the patient outside of the vehicle. He is unconscious and has obvious facial bleeding. Examination reveals a hematoma and depression of the lefttemporal area, both eyes are black and blue, and one pupil is dilated, whereas the other is normal. The patient has blood coming from the nose and mouth, and palpation reveals subcutaneous emphysema around the clavicles and chest area. The patient’s breathing is labored, and the pulse is rapid and thready.What is the priority for this patient?

You are dispatched to a private residence for a person reporting abdominal pain. You arrive to find a 25-year-old man lying on the couch in the fetal position. The patient states he was tackled while playing football 3 days ago and he now has pain that is becoming progressively worse. He is pale and diaphoretic. A physical examination of the abdomen shows bruising over the right and left upper quadrants, rebound tenderness, and guarding. The patient states the pain radiates to his right shoulder. Assessment of his vital signs shows a pulse rate of 130 beats/min, a blood pressure of 90/60 mm Hg, and respirations of 24 breaths/min.Bruising over the right upper quadrant could indicate injury to which of the following?

You and your partner are dispatched to the rodeo arena for a person reporting shortness of breath and chest pain. On arrival you are escorted to a first aid trailer where you find a man in his mid 30s seated in a chair and leaning forward clutching his chest. He tells you that he was riding a bull when he was thrown off. He states that he landed hard on his right side and heard a “loud pop.”While en route to the hospital, the patient suddenly grabs your arm and states that he can’t breathe. He appears pale, diaphoretic, and extremely anxious. Reassessment of the chest reveals diminished breath sounds on the right side and subcutaneous emphysema. You suspect which of the following conditions is developing in the patient?

You are dispatched to a private residence for a person reporting abdominal pain. You arrive to find a 25-year-old man lying on the couch in the fetal position. The patient states he was tackled while playing football 3 days ago and he now has pain that is becoming progressively worse. He is pale and diaphoretic. A physical examination of the abdomen shows bruising over the right and left upper quadrants, rebound tenderness, and guarding. The patient states the pain radiates to his right shoulder. Assessment of his vital signs shows a pulse rate of 130 beats/min, a blood pressure of 90/60 mm Hg, and respirations of 24 breaths/min.On the basis of your findings, which of the following best describes the patient’s condition?

You and your partner are dispatched to the rodeo arena for a person reporting shortness of breath and chest pain. On arrival you are escorted to a first aid trailer where you find a man in his mid 30s seated in a chair and leaning forward clutching his chest. He tells you that he was riding a bull when he was thrown off. He states that he landed hard on his right side and heard a “loud pop.”The patient finds it difficult to take a deep breath and speak. On the basis of this information, what should be your first intervention?

You and your partner are called for a 25-year-old man who was found unresponsive by two hikers in a remote area of a national forest. On arrival, you observe a young man lying supine on the ground with a liquor bottle nearby. Despite near-freezing temperatures, he is dressed in a T-shirt and jeans.Rough handling of a patient with severe hypothermia may cause which of the following dysrhythmias?

You and your partner are assigned to a post at an extreme sports competition. You are called to assess a 23-year-old man who was performing a midair trick on his bike when he lost control and landed on the bottom of the concrete ramp. When you arrive on scene, the patient is awake and alert and in extreme pain. He tells you that he flew over his handlebars and felt both of his upper legs snap. He denies experiencing any loss of consciousness.What device might be used for this patient until spinal motion restriction can be achieved?

You and your partner are assigned to a post at an extreme sports competition. You are called to assess a 23-year-old man who was performing a midair trick on his bike when he lost control and landed on the bottom of the concrete ramp. When you arrive on scene, the patient is awake and alert and in extreme pain. He tells you that he flew over his handlebars and felt both of his upper legs snap. He denies experiencing any loss of consciousness.The primary goal of placing the patient’s legs in in-line traction is to:

You and your partner are called for a 25-year-old man who was found unresponsive by two hikers in a remote area of a national forest. On arrival, you observe a young man lying supine on the ground with a liquor bottle nearby. Despite near-freezing temperatures, he is dressed in a T-shirt and jeans.After establishing unresponsiveness, what should be your next step in patient management?