You are dispatched to an out of town 911 for a 34 year old male,
unconscious, breathing, chief complaint of fall from a roof. You
arrive on scene without incident and find law enforcement on
scene as well. Scene is safe upon arrival.
Upon arrival you find law enforcement holding c-spine of the
patient who is supine on the ground. Cyanosis is noted on his lips.
The patient does not rouse with verbal or painful stimuli. The
patient has noticeable snoring and irregular respirations. Family on
scene reports he was working on the roof of the barn, which is
approximately 30 feet, when he slipped and fell off. The ground he
had landed on is dirt and gravel, no cement. The patient had landed
on his upper back, neck, and had hit his head. Patient has no past
medical history, no medications, and no allergies. No drug or
alcohol use is reported.
Upon further examination you find that the right pupil is 7mm and
non reactive. Left pupil is 4mm and reactive to light. Lung sounds
are diminished on the left side, clear on the right side. Abdomen is
soft and non rigid. The patient has crepitus to the cervical spine,
approximately c4-c6. A small amount of blood is observed coming
out of the patients nose. The patient has no gag reflex.
It’s you, your AEMT partner, and law enforcement present on scene. How would you like to care for this patient?
