Prehospital Cases

11yr old girl, thrown from a sideshow ride, landing on concrete.
Initial obs: GCS 3, HR tachy, BP hypotensive.
2nd survey: nil external haemorrhage.
So, RSI has been mentioned. What drugs, and what doses? And if you had no RSI available, would you intubate cold?
BP was 70 systolic. Fluids? How much and what type?
HR was 160 in sinus tach. RR fast, shallow, poor chest wall movement, minimal air entry. Finger Thoracostomy if not intubated? Needle
decompression? What size needle?
And what about hypertonic saline? Any place for it?

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