A 25-year-old man is brought to your facility by EMS transport following an accident while riding a bicycle. Witnesses say he was hit by a car when he suddenly tried to cross a busy intersection. They also report that he was not wearing a helmet and that he was thrown off the bike, landing several feet away.
Initial survey reveals a male who is arousable but nonverbal, just moaning and groaning. There are obvious deformities in both lower extremities and the right upper extremity. The patient’s blood pressure is 100/50 mm Hg and his heart rate, 130 beats/min. Pulse oximetry shows his O2 saturation to be 95% with 100% oxygen via nonrebreather mask. His pupils are equal and reactive bilaterally. Heart and lungs sound clear. Abdomen is soft.
While you continue examining the patient and begin your secondary survey, a portable chest radiograph is obtained (shown). What is your impression?
