Hematology Case Study
Chief Complaint: Injury to a roofer who fell off a 2 story roof while working.
History: This injury occurred in an otherwise healthy 31 year old male who was working in an awkward position and fell off the roof sliding over a substantial area of sharp partially constructed materials. This fall was located at a job site that was up in the "mountains" at a retreat home being built by a corporate individual and was in a hard to access region. Fellow workers reported that it did not appear that this individual hit his head and he was wearing a helmet at the time. He hit the ground feet first and collapsed to the ground shortly after (reports indicate within 5 seconds). The worker was awake and cognizant when his other coworkers including the foreman arrived within a minute of the accident. The individual had numerous "cuts and scrapes" over his exposed regions and workers also noticed that there was a lot of blood associated with his right arm and chest. This volume of blood seemed to be increasing steadily as they attended to him. Upon further exam, it appeared that he had an injury to his right arm in the armpit area and the majority of bleeding was originating from here.. Workers (several of which had first aid or EMT training) applied both a pressure bandage and a makeshift tourniquet to the upper arm/shoulder region with moderate success. A satellite cell phone call was made to 911 and a helicopter located and evacuated the man within 20 or 25 minutes of the accident.
The paramedics placed two large-bore catheters and began infusing physiologic saline intravenously. During transport, the patient became increasingly disoriented. The helicopter trip to the hospital took approximately 10 minutes.
There are no known allergies, or other health risks known about this individual and he was in good health according to his coworkers. The health workers attempted to contact the injured party's family, but they lived in a different region of the country and could not be reached.
Physical Exam: The patient was very lethargic upon admission, but was responsive to loud stimuli. Multiple abrasions and contusions were noted on the face, anterior thorax and abdomen. Examination also noted a deep, 10cm laceration in the right axillary region. The clothing and improvised tourniquet in this region were heavily soiled with blood.
Facts/Vitals:
Height 5'11"
Weight 185#
