CASE STUDY 13 - Emilio Hernandez

Emilio Hernandez is a 19-year-old college student who was rock climbing and fell 30 feet to the ground. He is 6 feet 7 inches tall and very active on his college basketball team. His medical history is negative except for the usual childhood illnesses and minor accidents. At the time of his injury, he was unable to move any extremities and complained of neck discomfort. He was awake, alert, and able to answer questions appropriately. He had no feeling in his arms or legs. On physical examination, Emilio's pupils were equal and reactive to light. There were several scrapes on his arms. His blood pressure and heart rate were 110/72 and 86 beats/min, respectively. His respirations were 18/min, unlabored, and regular but shallow. Paramedics applied a cervical collar at the scene, placed him on a backboard, immobilized his head, and transported him to the medical center by helicopter.
In the emergency room, further physical examination revealed no deep tendon reflexes. Emilio did have sensory perception from his head to just above the nipple line of his chest. He was unable to expand his chest wall. His color was poor, but his skin was warm and dry. His blood pressure and heart rate were now 110/60 and 68 beats/min, respectively, with respirations at 24/min.

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