Chest pain an low spo2 after crash

nymedic9999 said:
Yeah he was boarded and collared as per our protocol. I didnt think about the possibility that the board was causing his low spo2. That is probably very likely. So in this case ALS probably could be deferred. I was concerned of a possible pneumothorax.
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The supine position and his age/comorbidities almost assuredly are responsible for the lower SpO2. Even healthy people suffer a measurable degree of respiratory insufficiency while boarded/collared.

Without crazy anxiety or other vital sign changes, the likelihood of a PTX is low. Err, let me restate that, the likelihood of a clinically significant PTX is low.
 
Eighty years old, fifteen minutes to get ALS (ten for extrication plus remaining five if all goes as planned) plus time to hospital...

Oxygen, spinal precautions with care to not compromise respiratory efforts, get to hospital. Continuous reassessment. Prepare for good handoff at receiving facility.

Think, what's in the right lower chest? Depending upon how low it is, it can be diaphragm, rib, liver, bowel, kidney, lower right lobe of lung, or even insult of a spinal nerve root serving that region. DEVELOPMENT of it may just be initial shock and adrenaline wearing off, or a worsening of general condition.

What I'd want is to pull over on the way to the hospital, with a potentially worsening post-MVA 80 y/o male, to get him pain relief...yeah, uh-huh.
 
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