ABSTRACT
This chapter presents a case study of a 35-year-old male who was the driver of a vehicle involved in a head-on collision with another vehicle. On arrival to the resuscitation area of the Emergency Department, he is confused and disorientated, unable to confirm his name or age. The patient has sustained blunt trauma that has caused cardiac tamponade, bilateral haemothoraces and hypovolaemic shock. The commonest cause in an injured patient is hypovolaemic shock due to blood loss, but other causes include cardiogenic shock due to myocardial dysfunction, neurogenic shock due to sympathetic dysfunction or obstructive shock due to obstruction of the great vessels or heart. The medical students and junior doctors should not wait for a trauma patient to develop hypotension before starting fluid replacement therapy. Ensure that the patient is haemodynamically stable before transfer to the CT scanner as transfer times may be prolonged and deterioration whilst en route or in the scanner is difficult to deal with.
