In the case study provided, the unconscious patient needs an assessment and a differential diagnosis completed so that the paramedics know how to treat and to determine if the patient is time or transport critical. A differential diagnosis comes from the paramedics’ education and the patient’s history, current vitals signs, and pertinent knowledge gained from those at the scene. The paramedic must, after the differential diagnosis, have an understanding of the pathophysiological process and how this affects the patient. Due to the patients mechanism of injury they need to be treated as a suspected spinal injury. The patient is to remain still, and requires the paramedic to immobilise the head and neck of the patient without traction (Greaves, Hodgetts, Porter, & Woollard, 2012). A semi-rigid collar needs to be used to help support the head and neck, however the patients head still needs to be immobilised manually to prevent further injury (Greaves, Hodgetts, Porter, & Woollard, 2012). When moving the patient the technique used is a ‘log roll’ (Greaves, Hodgetts, Porter, & Woollard, 2012). With this technique will require assistance of bystanders is necessary so that stability of the spine is preserved (Greaves, Hodgetts, Porter, & Woollard, 2012). The patient will be log rolled onto their right side because of the injury on the left, if they have trauma in their chest cavity log rolling onto their left side could exacerbate the injuries (Greaves, Hodgetts, Porter, & Woollard, 2012). Once patient is on their right side a spinal board needs to positioned inline with the back, head and toes so when they are rolled back into a supine position they are correctly on the spinal board (Greaves, Hodgetts, Porter, & Woollard, 2012), however before the patient is returned into the supine position a head to toe assessment of the patients back, especially spine needs to be performed and note any suspected spinal injury (Greaves, Hodgetts, Porter, & Woollard, 2012).
Once the patient is in the supine position treatment for a possible tension pneumothorax can occur, a thoracic decompression, if within their scope of practice, can be completed by a paramedic to release pressure in the left lung. A thoracic decompression is completed by using a 14-gauge cannula that is connected to a 10ml syringe. The cannula is then inserted into the second intercostal space in the midclavicular line on the left side of this patient (Greaves, Hodgetts, Porter, & Woollard, 2012). The aim of this treatment is for the pressure within the chest cavity to decrease and to equalise pressure, and lower pain levels of the patient (Greaves, Hodgetts, Porter, & Woollard, 2012). However, if pressure and symptoms do not diminish the paramedic must begin treating for a haemothorax. Treatment of...