David W. Ross

Car Versus Bicycle

The following column recounts an actual patient case involving a critical care transport. Minor details of the case may be changed solely to protect the privacy of the patient. The initial presentation and treatment will be described and followed by several questions in this issue. Readers are invited to submit responses to the questions and other thoughts/comments to David Ross, DO, at DRDR0682@aol.com . In the next issue, relevant reader responses will be published. We will conclude the case in the next issue with a discussion of how the patient was actually managed, the outcome, a review of the related medical literature, and interviews with medical/transport experts where appropriate. We strongly encourage reader participation.

Car Versus Bicycle: Conclusion

A 58-year-old man was riding his bicycle and was struck by a car. He was ejected and landed on his back on the pavement of the roadway. He complained of severe pain in his lower back and sacral area. Ground emergency medical services (EMS) arrived to find a pale, diaphoretic man who was alert but in distress. His medical history was negative, and he was taking no medications. The initial heart rate was 130 beats/minute, and the blood pressure was 70 mmHg by palpation. A helicopter air ambulance was requested from the rural scene location to transport the patient to a trauma center. The physical examination by the flight crew demonstrated the patient had not changed from the original EMS assessment, despite the administration of 1 L normal saline intravenously. There were no apparent injuries to his head, neck, chest, or extremities.

Critical Burn Patient with an Unknown Neuromuscular Disease

The following is a recount of an actual patient case involving air transport. Minor details of the case may have been changed, solely to protect the privacy of the patient. The initial presentation and treatment will be described, followed by several questions, in this issue. Readers are invited to submit responses to the questions and other thoughts or comments to David Ross, DO, at DRDR0682@aol.com . In the next issue, relevant reader responses will be published. We will conclude the case in the next issue with a discussion of how the patient was actually managed, the outcome, a review of the related medical literature, and interviews with medical/transport experts, where appropriate. We strongly encourage reader participation. If you have a case that might be suitable as a subject for Case Review, please submit the details to David Ross at the above email address.