Abstract
pressure of 109/61, heart rate of 73, and oxygen saturation of 93% on room air. His past medical history was significant for only hypertension. A chest x-ray and cat scan of the abdomen/pelvis demonstrated multiple left-sided rib fractures with resultant moderate pleural effusion and pneumothorax and no intraabdominal pathology. A left chest tube was placed, returning 700ml of blood. The patient became immediately hypotensive to a nadir blood pressure of 55/37. He was emergently intubated and had an internal jugular triple lumen placed. Repeat labs demonstrated a hematocrit drop from 31 to 21 mg/dl. He was started on a dopamine drip and given 2 units of uncrossmatched packed RBC. A Repeat cat scan of the chest, abdomen, and pelvis was performed that demonstrated a new moderate pericardial effusion. His condition temporarily stabilized with these measures and he was then urgently transferred to a nearby tertiary care center.
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