Boating trauma

This case comes from JoAnne Slinn.

JoAnne is a nurse (background in emergency nursing) and one of the Sim Knowledge Coordinators based at the Pritchard Simulation Centre in Kelowna, BC. JoAnne has her master of nursing degree and nurse practitioner designation and is passionate about all things sim!

WHY IT MATTERS

Patients in hemorrhagic shock require blood products expeditiously as well as identification and definitive management of the source of bleeding. This case provides an opportunity to practice identification and treatment of multiple sources of blood loss in hemorrhagic shock.

CLINICAL VIGNETTE

25 year-old male was involved in a boating accident. He was waterskiing and was struck by another boat at high speeds. He sustained significant propeller injuries to right leg, unstable pelvis, and abdominal bruising. No LOC but altered with some reported alcohol consumption. Was wearing a life jacket with minimal submersion. He was quickly pulled out of the water by his friends with significant blood loss on scene. EMS applied combat application tourniquet to leg on scene 45 minutes ago. Pelvic binder applied, spine stabilized, and IV established in Rt AC with 1L NS infused. TXA 2 gm given and methoxyfluorane for pain control enroute.

CASE SUMMARY

25 year old male is involved in a boating accident. He was in the lake waterskiing and struck by another boat, sustaining blunt abdominal and pelvic injuries and significant propeller injuries to his leg. The trauma team will be activated and he will be brought to the ED. Treatment includes tourniquet application to the limb and rapid blood product administration. Intubation for clinical course and pain management need to be addressed with disposition to the operating room.

Boating Trauma Download