This middle-aged obese man was admitted
following a motor vehicle crash. His major injury was chest trauma with
a small right pneumothorax and at least five fractured ribs on the
right. There was no head or neck injury. Abdomen was soft and CT scan of
the abdomen was normal. He was
haemodynamically stable with BP 130/80 and pulse 90/min. Heart sounds
were normal. Respiratory distress was present. Respiratory rate was 30/min.
Saturation was 95% on high flow oxygen via face mask.
Investigations: Na 138, K
3.9, Cl 103, HCO3 21, glucose 13.6, urea 5.5, creatinine 0.10
TO BE COMPLETED
Firstly, initial clinical assessment: