CASE STUDY 19 - Charles Simpson

Mr. Charles Simpson, 20 years old, is injured in an industrial accident, resulting in a crushed pelvis, ruptured spleen, and associated blood loss. His past medical history is negative for previous trauma or chronic illness and positive for usual childhood diseases. Before the accident Mr. Simpson was in good health and exercised daily. His height is 6 feet and weight 165 pounds.
At midnight a 10-ton forklift fell and pinned Mr. Simpson at the pelvis for about 20 minutes. Paramedics at the scene began intravenous lactated Ringer's solution at 150 ml/hr. Vital signs were heart rate 120 beats/min, blood pressure 90/70, and respirations 46/min. Mr. Simpson was awake and complained of pelvic, back, and abdominal pain. His toes were mottled, pedal pulses were absent, radial pulses weak, and brachial and carotid pulses palpable. The electrocardiogram monitor reflected tachycardia, and he became short of breath with conversation. Skin was cold and clammy, with numerous pinpoint hemorrhages present over his upper thorax, face, and neck.
Mr. Simpson was transported to the hospital, where his injuries were diagnosed and immediate treatment for shock initiated. After stabilization, his ruptured spleen was surgically removed, he was placed in pelvic traction to stabilize his fractures, and he was admitted to the intensive care unit.

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