Motor Vehicle Accident Medical Question
A 32 year old man is brought to the emergency department after being involved in a motor vehicle accident. He is complaining of abdominal discomfort and severe back pain. He was placed on a board at the site of the accident for spinal immobilization. His blood pressure is 114/76, pulse is 56/min and regular, respirations are 17/min. Pulse Oximetry on room air is 97%. There are several lacerations on the face and anterior chest. There are normal breath sounds bilaterally. Patient is alert and fully oriented. There is decreased pain sensation and weakness in both legs. Proprioceptive sensation is preserved. Chest x-ray and CT scans of the abdomen and spine are performed. Which of the following is the most appropriate next step in management for this patient?
A) Femoral line placement
B) IV atropine
C) IV lorazepam
D) Bladder catheterization
E) Nasogastric tube placement
–USMLEWORLD,LLC QBank ver 2009.02
Correct answer is D) Bladder catheterization. Patients with traumatic spinal cord injuries should first be hemodynamically stabilized and have proper airway management. An important next step is urinary catheter placement to assess for urinary retention and prevent bladder distention and damage.