A woman has fallen from a second-story window onto the concrete sidewalk below. She is unresponsive and has a large depression to the back and top of her skull. Additional findings include abdominal bruising and an angulated left ankle. Your partner reports that the patient's vital signs are: pulse 68, respirations 14 and irregular, blood pressure 198/110 mmHg, and SpO₂ 91%. Based on these assessment findings, which one of the following should the EMT recognize?

Question

Quizplus · Accepted Answer

The patient's mechanism of injury and physical exam findings, including the unresponsive state, the large depression to the back and top of her skull, and the low oxygen saturation, are all suggestive of a severe head injury, likely with increasing pressure within her skull. The elevated blood pressure may be due to the body's response to the injury and may be contributing to the increased intracranial pressure. Abdominal bruising may also be present due to the impact of the fall. Bleeding within the head is a concern, but shock is not typically caused by bleeding alone. Untreated hypertension is a possibility, but it is not the most likely cause of the patient's presentation given her mechanism of injury and physical exam findings.

A Woman Has Fallen from a Second-Story Window onto the Concrete