Gack. For a story I’m writing (well, re-writing, my NaNo ‘masterpiece’): Say someone’s in a bicycle-meets-car type accident and has some sort of head injury (concussion?). Their helmet is cracked, they’re unconcious. Their friend who’s with them manages to get them vaguely awake, but they’re not coherent, drifting in and out of consciousness. They also have a badly broken leg - the type of injury where they need surgery to fix it.
- Friend calls 911 from his cell, the paramedics get there. What do they do? I don’t need huge details, but the only time I’ve witnessed a situation involving an accident scene, I was the concussed one, so my memory is a bit fuzzy to say the least.
- I’m assuming at the hospital any possible internal injuries and the head injury take huge precedence. What do they do for a suspected bad concussion? Does it generally resolve itself or do they give some sort of drugs for it?
- Say she needs surgery for her leg. I know that if someone has a bad concussion, it’s best not to let them fall deeply asleep, for some reason. Do they just wait a couple hours before going to work on her leg, or what?
Anecdotal evidence just as welcome as professional. I don’t need hugely detailed info, as I’m writing it as “I don’t remember because I was unconscious, but my friend said that x happened”. However, if you want details, I’m fine with that, as my curiousity knows no bounds.
I was in a bicycle vs. car accident last June. I probably had a concussion,my helmet was badly damaged although I had no loss of consciousness. I did pass out(or sedated) in the helicopter. I was taken to the ER and then to the OR as I was bleednig heavily. i had a broken femur and a large hole where part of my hamstring used to be. I dont know what the timeline was but i did have CT scans from head to foot.
The paramedics would arrive at the scene, ask what happened, look in your eyes to check your pupils, listen to your heart. They would not move you until they had rigid neck collars and back board ready. They would move you on to the board AS IF YOU HAD A NECK FRACTURE (until proven otherwise). They would take you to the hospital.
The hospital would check the airway, lungs and pulses. They would recheck the pupils. If the patient had a decreased level of conciousness or had difficulty breathing they may intubate the patient using ketamine (with or without propofol), etomidate, or other drugs that don’t increase intracranial pressure.
They would check the pupils, palpate the neck and likely get X-rays of the neck (and possibly the back, skull, chest, hips, etc.). “Life-threatening” injuries take precedence over “limb threatening” injuries. They would indeed be intubated and sedated for leg surgery – patients don;t need to be forcibly kept awake, although they need to be awakened on a regular basis after a head injury.
CT scans would be important if there is thought to be a serious head injury, as you describe, to rule out an intracranial hemmorhage, which may require neurosurgery.
Dr_Paprika, that’s extremely helpful. Thanks!