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Focus: Neurological System and Skeletal System

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Gilbert Loeppky is a 36-year-old married man. He drives a delivery truck in a busy city. He often works long days, sometimes putting in more than 16 hours a day. He works hard, and he is well liked and respected by colleagues, friends, and family. He occasionally wears glasses to read.

Today, Mr. Loeppky—or Gil, as he likes to be called—was in a motor vehicle accident on a main street in a commercial district. Two vehicles (his truck and a car) collided at an intersection around noon. The impact sent his truck swerving across the road and up onto the sidewalk. The truck came to a stop when it slammed into a power pole. The left front side of the vehicle was severely damaged.

According to police on the scene, Gil was not wearing his seat belt at the time of the accident. The force of the crash pushed the hood of the truck inward. Gil's head came into contact with the windshield and molding. His feet and legs appeared to be trapped, but the EMT had no difficulty extracting him.

Gil was found in an unconscious state by emergency personnel. He was suffering from facial lacerations, head trauma, and a fractured leg. As a result of the seriousness of his injuries, Gil was immediately transported to the Emergency Room of Okla Trauma Center by Rescue Unit 112 of the Fire Department.

Patient Update

"What have we got?" called out the emergency physician as the Emergency Room doors swung wide on their electric hinges.

"Adult male. Name's Gil Loeppky. Head trauma; loss of consciousness. Reactive to pain, so may not be a spinal injury. We put the collar on him. Vitals stable but high. BP 140/80, pulse thready at 100 and holding. ECG okay. No apparent internal injuries. Looks like a fracture of the right femoral. Superficial bleeding from lacerations to the face. Hematoma, left and right orbital. No apparent fracture there," reported EMT Stanley as he and EMT Raybuck unloaded Gil Loeppky from their rig and rushed him in through the hospital doors. "We started an IV. O2 by nasal prongs."

"Sir, sir… can you hear me?" queried the physician, with his face close to the patient and his voice loud, while running alongside the gurney. "Sir, can you hear me?" As they approached the trauma bay, nurses and technicians swarmed into it. As a team, they carefully lifted the patient up and onto the hospital stretcher. Gil groaned loudly when this occurred. "Mr. Loeppky, this is Dr. Raymond. You've been in an accident. You're at Okla Trauma Center." Dr. Raymond began the emergency assessment: He checked Gil's airway, breathing, and circulation, and he then assessed for Gil's level of consciousness. Once again, Gil responded to the pain assessment, but he did not awaken.

"Let's get him up for x-rays, guys. I'll want a head CT ...

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