Clinical scenario: 8-year-old female involved in a vehicle collision

You are asked to respond as the third unit to arrive at a vehicle collision

"Medic 17 respond third unit in for a multiple vehicle collision on US-686 at mile marker 22."

En route to the call you receive an update that the incident command system has been activated for a 10-vehicle collision that appears to have been caused by heavy winter fog conditions. Triage is ongoing, but two immediate patients have been identified and transported. You arrive on scene and check in with the firefighter working as the staging area manager and are directed to the transport group.

You are immediately assigned to transport an immediate/red-tag patient. Becky is an 8-year-old female who was sleeping in the back seat of an SUV which rolled over during the course of the multiple-vehicle collision. She is alert and oriented and states that she was not wearing a seat belt and was lying across the bench seat in her parents’ SUV.

Becky denies head, neck and back pain and does not have any obvious trauma. She does not clearly recall the events of the collision. She currently has a GCS of 15. She complains of 8/10 abdominal pain and has some diffuse bruising on her abdomen.

Becky’s vital signs are:

  • B/P – 90/68
  • HR – 134
  • RR – 34
  • SpO2 – 98%

Think about these questions as you consider what to do next:

  • What are some potential injuries based on Becky’s mechanism?
  • What other assessments would you perform?
  • What is your working diagnosis?
  • Does anything concern you about her presentation?
  • Is it important to keep Becky with her parents?

Post your answers below in the comments and view the clinical solution for this patient.

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