Trauma in Pregnancy – Clinical Case

You have received a pre-alert. There is an ambulance en route bringing a 32-year-old, restrained female driver, who has been involved in an RTC. This occurred 15 minutes ago. The patients car has hit another car coming from the other direction in a 30 mph zone and then hit a tree. She had to be extracted by the crew as they were unconscious.

The patient is currently confused, is complaining of abdominal, hip, and leg pain. Her abdomen is distended. The fundus is palpable above the umbilicus; there is a shortened, internally rotated right lower limb with a swollen thigh and open fracture of the left leg. The crew is suspecting a head injury, abdominal injury, right proximal hip fracture and left leg open fracture.

Reported observations are HR: 130bpm, BP: 162/98 mmHg, RR 22bpm, oxygen saturations 99% in room air, temperature of 36.8C, GCS 13/15, BM of 5.2. Treatment given: Morphine 10mg IV + Ondansetron 4mg IV, vacuum splint applied to left leg, 500ml of 0.9% Normal Saline. ETA 5 min.