A 47 year old male was shot in the back. He is cool and clammy and has arm weakn

Question

A 47 year old male was shot in the back. He is cool and clammy and has arm weakness. Vital signs are BP 130/90, P76, R24

Tension Pneumothorax

Aortic transection

Massive hemothorax

Spinal Cord injury

A man has a knife impaled at the fourth intercostal space, left sternal border. He is pulseless and not breathing

Stabilize with a bulky dressing

Perform compressions with the knife in place

Remove the knife from the chest

Not attempt to perform compressions

A trauma patient has several wounds oozing blood. After completing the scene size-up you should

Immediately dress and bandage all wounds

Ask the patient if he has hepatitis or HIV

Ensure that the patient has an adequate airway

Do a complete head-to-toe patient

A 45 yr old male fell asleep outside while doing yard work. His face and lower legs are bright red with small blisters and painful on examination.

Allergic reaction

Alcohol intoxication lead to prolonged exposure

Both superficial and partial thickness burn

Both partial and full thickness burns

A 53 year old femal was hit by a car. She is unresponsive with deformity to the left femure and pelvic instability she has dimished lung sounds on the left side. You should

Immobilize her onto a long backboard

Stabilize the left femur with a traction splint

Perform a detailed physical assessment

Rapidly transport to the nearest emergency room

A 23 year old soccer player was kicked in the chest. He is alert with rapid, shallow respirations and complains of chest pain. Skin is pale, cool and wet

Oxygenate via non-rebreather mask

Palpate the chest for tenderness

Insert a nasopharyngeal airway

Perform a rapid trauma assessment

Explanation / Answer

Q1. A 47 year old male was shot in the back. He is cool and clammy and has arm weakness. Vital signs are BP 130/90, P76, R24

Answer: Spinal Cord injury

The patient is probably suffering from Spinal Cord injury. Arm weakness is commonly associated with spinal cord injury and this injury could be the reason for the cool and clammy skin. This is called non-thermoregulatory reflex sweating (also common in Spinal cord injury). Although, stress could lead to slightly higher rate of breathing and elevations in BP, the slight increase in blood pressure in this patient may be due to lower back spasms that could temporarily contract the muscles in the area, restricting the blood flow at the injured area.

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