Interview case

Question 1

Patient run over and had femoral fracture and was bleeding out. How would you manage this patient?

Answer 1

First need to check for any danger to myself, need to stop cars and not get run over myself. Get other people to stop traffic.
cA-E approach so cataustrophic haemorrhage dealt with first
Apply improvised windlass torniquet if the patient is going to bleed out, note down time of application of torniquet
Then follow A-E to assess the rest of the patinet
Get someone to ring an ambulance and use ATMIST to relay the details of the patient.

Question 2

What are the different types of shock?

Answer 2

Cardiogenic
Hypovolaemic
Peripheral circulatory failure e.g. sepsis and anaphylaxis

Question 3

What is the likely management of the femoral fracture patient?

Answer 3

cABCDE
If open fracture then would follow BOAST 4 and give antibiotics (coamixiclav) then immediate surgery if neurovascular compromise
If the fracture is closed then would aim to reduce the fracture using a kendrick splint by the paramedics then maybe a thomas splint in hospital
Make sure the patient has sufficient analgesia
Need a CT to plan surgery/Management