A 28 year old male was involved in an motor vehicle accident; his motorcycle hit

Question

A 28 year old male was involved in an motor vehicle accident; his motorcycle hit a median divider, and he was brought to the ER. Innitial laboratory values were within normal limits. CT scan showed no evidence of liver or spleen laceration. One liter Ringer's lactate was infused along with two (2) units of blood. while en route back to the ER from the X-ray facility, the patient complained of chills, chest pain, and flank pain. Vital signs were significant for hypotension and tachycardia. Blood work was significant for anemia.

What is the most likely cause for his hypotension and tachycardia?
what is the best course of action for this patient?

Explanation / Answer

The likely cause for his symptoms is injury to the kidneys. The flank pain indicates this possibility and the anemia is due to the blood loss. The instability of vital signs is hypotension, chills and tachycardia. The chest pain might be due to abrasions received in the fall. The best course of action is to regulate fluid intake and to advise the patient to take bed rest. This would allow the kidney to heal itself gradually.

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