Final Draft Of Single Car MVC/ Includng MOI, Injuries, and Treatment.

Here is a picture Of a car accident. I had to write a paper on what I thought happened, what the injuries were of the driver and passenger, what I would have done to treat the patients, how I would transport them. I knew NOTHING about this accident before I wrote this paper. I am the Lead EMT on scene and I am to figure it out. What do you think, How did I do? I would LOVE feedback!!!!


HERE IS THE PAPER I WROTE....

Nakiya Royston
Car vs. House. MVC.

In this picture there is a head on collision with a house. The Mechanism of Injury was the house that the car drove/crashed into. I believe that he was driving at a high speed maybe missed a turn, lost control and ran into the house. Alcohol could have been a factor. Both the driver and passenger airbags deployed and the windshield is broken. I am not sure if it was the driver that hit the windshield or the hood of the vehicle that caused it to break/crack.
After checking scene safety and putting on my BSI. On my scene size up I would call ALS due to the likely severe internal injuries that these patients may have and a possible need for IV access. I would Request another EMS unit, due to the fact that there is more than one patient that may be seriously injured. If the fire department is not already on scene I would call for them as well; there may be need for extrication due to the front end being totally crushed in. Also the need for police is great due to the damage of the house, statements that need to be collected, for possible alcohol involvement, and crowd control.
The types of injuries I would suspect for the driver would be a direct impact of the steering wheel, and windshield although I cannot see the steering wheel closely It does not look deformed or bent, but there does seem to be blood on the airbag, So I would believe that the driver was unrestrained, went up and over the steering wheel, airbag and hit the windshield. This patient would have head injuries including significant whiplash due to the impact being so great, which would require immobilization with Cervical-collar and backboard, there also maybe some superficial burns to the face from the airbag. I would be highly suspicious of internal injuries due to the high speed impact into the house, which was stationary and would greatly increase internal organ trauma, specifically the heart, lungs, and other abdominal organs from the collision. Also chest injuries from hitting the steering wheel, so I would be paying close attention to his/her airway. If airway was patent I would put him or her on Non-Rebreather mask @ 15lpm, if breathing is not adequate Positive Pressure Ventilation with Bag Valve Mask @ 10-12 breaths a minute with oxygen. I would also suspect some sort of crush injury to his or her legs due to the front of the vehicle being completely crushed therefore splinting of any deformities or broken bones, and having to control bleeding, most likely to head and lower extremities.
If the passenger was restrained he or she most likely would have sustained minor injuries to legs, knees and bruising on the chest from the seatbelt. I would be suspect of internal injuries due to the speed of collision and impact. I would also immobilize this patient to a back board with C-collar due to the injuries to the driver. I would also put this patient on Non-Rebreather mask @ 15lpm if airway was patent, and if airway was not patent I would do Positive Pressure Ventilations with Bag Valve Mask @ 10-12 breaths a minute with oxygen. If the passenger was not restrained I would suspect him or her to have significant leg and chest injuries, and internal injuries due to the high speed collision impact even though the airbag did deploy also due to the major frontal impact. I would suspect bleeding from the head, major whiplash; also highly suspect breathing and airway problems, fractures to the lower extremities that may need to be immobilized with splinting. I would control any bleeding, and look for superficial burns on the face due to the airbag deployment.
I would stabilize the patients with the above stated injuries and then do a rapid trauma assessment on each patient to see if there were any other injuries other than the obvious that I saw on initial assessment, and treat accordingly. I would transport each patient supine, fully immobilized on back board with cervical collar in place. I would have my partner gather any additional statements and witness reports that were taken so we would have all possible accounts of the actions that occurred.
I then would load patients in truck, re-access vitals and if stable re-check vitals every 15 minutes and if un-stable every 5 minutes, get my sample history, OPQRST on route to the hospital. Notify closest trauma hospital with patient MOI, status upon arrival to patient, and current status. I would take them to the closest trauma hospital.