Chapter 18, Problem 3CCS

Mr. Hutchinson, another middle-aged victim of the collision on Route 91, has a tourniquet around his thigh when admitted in an unconscious state to Noble Hospital. The emergency technician who brings him in states that his right lower limb was pinned beneath the bus for at least 30 minutes. He is immediately scheduled for surgery. Admission notes include the following:

Multiple contusions of lower limbs

Compound fracture of the right tibia; bone ends covered with sterile gauze

Right leg blanched and cold, no pulse

Blood pressure 90/48; pulse 140/min and thready; patient diaphoretic (sweaty)

What do you conclude regarding Mr. Hutchinson’s cardiovascular measurements (pulse and BP), and what measures do you expect will be taken to remedy the situation before commencing surgery?