En RouteThe paramedic is dispatched to a residence for a 65-…
En RouteThe paramedic is dispatched to a residence for a 65-year-old patient who fell off a ladder. Dispatch reports the distance was approximately 14 feet. The time of the call is 1300. The response time is 10 minutes. The paramedic is partnered with an EMT, no additional resources are available at this time. The weather is clear, and the temperature is 77F (25C). A local community hospital is 15 minutes away and a comprehensive medical facility is about 25 minutes away. On Scene The patient (62kg) is found laying on the ground on their left side. There is an overturned ladder nearby. The wife reports the patient was cleaning out the gutter when she heard a crash. The patient was initially moaning but now she cannot wake him up. The patient has a history of hypertension and takes hydrochlorothiazide and atenolol. The patient is allergic to sulfa drugs. The initial exam is pertinent for pale, clammy skin. Blood and vomit are noted around the patient’s mouth. There is obvious deformity to the right leg with pooling of dark blood under his pants. The patient moans and draws his arms to his chest when the trapezius muscle is squeezed. A weak carotid pulse is present. Respirations are 28 and shallow.