Author: Basil Iqbal Sait, Vasavi Shenoy Bellare / Editor: Sarah Edwards / Codes: / Published: 25/09/2025
A 38-year-old male is brought to the Emergency Department (ED) as a trauma pre-alert following a motorcycle-versus-car collision at an estimated speed of 40 mph. He reportedly struck the rear of a stationary vehicle. He has an obvious deformity to his right forearm.
On arrival to the ED, he is alert and oriented with a GCS of 15. A structured primary survey was performed:
Airway is patent with cervical spine immobilised.
Breathing: RR 18, SpO 98% on air; with mild reduced air entry at both lung bases and right-sided chest wall tenderness.
Circulation: HR 88 bpm, BP 110/70 mmHg. No active bleeding, warm peripheries, distal pulses intact.
Disability: Pupils equal and reactive, blood glucose normal, no focal neurological deficit.
Exposure: Temp 36 C, covered with a blanket; visible deformity to right distal forearm.
The patient is administered IV tranexamic acid (TXA) and warm fluids. A full trauma CT (head to pelvis) is ordered to assess for internal injuries given the high-speed mechanism. Past medical history is unremarkable, with no known comorbidities or anticoagulant use. The patient is fit and well.
