sorry for the loss of such a great friend jordan. when it comes to evaling any patient for possible trauma injury, esp once they hit the ER is getting the initial CT scan of any potential place given the overall mechanism of injury that simply could have been impacted(the chest is ALWAYS checked out even when it is an MVA only becasue of the possiblity of severe chest compression trauma or severe "rebound' injury, and with a bike, possibly slamming chest into the front dash where the handlebars come out of too?).
the one possible thing here that i am thinking, only becasue at one point they DID actually clerar his heart lungs(upper torso/chest) would be a possible tearing of his aorta? this WOULD not always show itself right away depending upon how it was dissected in there, but once it got going, since this just IS the major upper blood supply with also very high pressure within the vessls, it would have been a very rapid and also major unstoppable bleed. i simply do NOT buy at all the "too much blood to see anything in there upon any scan"? only becasue, when that bleeding is just that heavy, it would also obscure any real ability to actually 'make out ANY real organs in there too, ya know what i mean? thats pretty much, for ANY real doc, a no brainer there? its VERY easy to see esp using CT vs MRI even? its simply how well CT actually shows any blood new bleeds AND older bleeds as well. this is why they always go to CT scans when trying to determine any level of brain bleed like a stoke too? it just shows blood better. just one "possible" here if he did indeed actually have some level of tearing within that aorta at all that was a slow ongoing bleed, it can pool in only the back showing nothing really in the front? but with just the way blood shows up upon CT, i simply cannot imagine any real good knowledgable hospital staff/ER docs who simply do SEE this stuff much more often than any others actually looking at the scans and NOT actually notice 'too much blood" being there?? something just does not "sound right" at all about this.
i worked many a trauma AS a medic and i am absolutely stunned just considering the overall mechanism of his injuries that whoever the heck was in charge of transport at the scene of that accident did NOT see fit to even WANT to have that man even checked out and transport him to an ER???? that REALLY bothers me just knowing what occured and how he actually landed as well? ANYONE who suffers THAT level of traumatic accident and off a bike no less just HAS to be fully evaled and very well scanned at an ER just to make certain there ARE no major underlying internal injuries. its kind of like EMS 101, basic, just considering what took place to the patient at all kind of thing? they were just plain stupid when the bascis were staring them right in the face there(the overall mechanism of injury dictates transport)? i am wondering just who these "ambulance drivers' were as far as actual paramedics, EMTs or mere first responders from the local FD? that would dictate what stupiditiy could simply occur at the scene of ANY given accident or injury too? they ONLY would know what 'their' overall level of training allows them to? or simple lack of true experience depending how long they had been actively working and transporting patients too kind of thing? alot of different things make a good medic or diagnostician when working any level or trauma out in the field transporting and treating.
honestly? in MOST situations like with your friend, we would usually spend much more time actually trying very hard to even "convince' an accident victim to actually even BE transported only becasue we just knew what 'could' have occured due to their level of trauma, not the other way around at all. they just 'feel" okay and think they are fine when part of that is just the overall shock mode they go into and are not actually thinking about the what ifs real clearly either? that IS the main reason we try like heck to get them to simply be evaled in the ER.
you only transport every patient as your friends situation was ONLY becasue of that one possiblity of underlying deeper injury(HAS to be ruled out or in, and he very obviously did indeed HAVE some level of underlying bleed going on or this would NOT have actually occured either). a possible lacerated liver or spleen would be the more "commonly" found reasons for internal bleeds to even occur with that type of trauma, or most definitely, even with a helmet on, the concussive forces could very easily create some level of head trauma that does NOT always show itself right away, same with other possible injuries here too. adults simply tend to really 'compensate" much better becasue they are simply stronger too? the fact just IS not all internal injuries or even major bleeds will actually just show themselves immediately after any accident or level of trauma. thats why the people who assessed and evaled your friend at the scene really were NOT looking out for HIS best interest in telling him NOT to be transported. it should have actually been encouraged given the situation and mechanism of injury. this whole thing just sounds really strange to me anyways just knowing what the 'standard' protocals actually are for ANY potential trauma patient and just basic common sense too here?
one thing here jordan. while i can certainly tell you do not live in the USA where i do, i am wondering what IS automatically even "done' as far as even HAVING an autopsy done to REALLY determine casaue of death goes? unless the family requests an autopsy be perfomed on ANY patient, with exception of the police needing it for a possible crime having been commited, that casue of death that shows up from that coroners office in most cases will actually state exactly what you were already told AS the underlying cause of death in that ER that day? its just the way things go here in the US anyways. hopefully they will do that needed autopsy esp in light of what they are listing as cause of death here? that has NOT been actually even totally proven at this point, only the 'impressions' of the on staff that day docs who worked his actual case? ya know what i mean? no one, without actually looking into that chest can really even say with any real certainty just what it was that created such a massive bleed in there.
this is just some stuff per standards i thought you needed to be aware of hon.
again, i really am so sorry you lost such a wonderful friend jordan, and at such a young age too. please let me know just what you find out,K? FB
