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This question was answered on Sun 10, Aug 2008 10:04am by Dr Simran, MD
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I need some information on the following scenerio from a novel i am writing. Please help me with my RTA scene.



Asked by Unregistered 00 on Sun 10, Aug 2008 08:46am :

It is late one Sat night (around 12-1ish). I have four friends on their way back from a party they have all been drinking, There is accident (not sure of circumstances yet) but car is driven off the road on a stretch of roadway circumventing the lake by their town, ends up going over a small ditch and crashes into a big tree at around 50mph. The driver (my 20 year old) is very badly injured and he dies later. Back passengers fare a little better but still have very bad whiplash and a couple of broken bones. My Main Character the youngest (16) is in front pass seat , takes full brunt of impact with tree and fractures 6 ribs (I was thinking 4 one side 2 on other) one of the broken ribs has punctured his lung and he is bleeding into his lung cavity. I was thinking of various cuts and bruises too. I suppose after that kind of impact he would be trapped, not sure. I need some sort of complication to make it life threatening, although he has to survive. He is having difficulty breathing. I was wondering whether you might be able to help me. I am writing a novel in which i have scenerio in which my MC who is just turned 16 is involved in a car accident. He gets a several broken ribs and a puntchard lung. In the chapter I have him arriving at an A & E dept from the ambulance. is it possible for you to give me an idea of 1) what emergency treatment he would receive including what pain relief and 2) what subsequent care he would get and how long he would likely be in hospital and 3) what complications there might be and how they would be treated. 4) What would the ambulance staff say to the A & E staff about patient when he first arrived?
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Answer by Dr Simran, MD (doctor) on Sun 10, Aug 2008 10:04am:

Hello annanan, Pneumothorax is a collection of air or gas in the chest or pleural space that causes part or all of a lung to collapseA small pneumothorax may resolve on its own, but most require medical treatment. The object of treatment is to remove air from the chest and allow the lung to re-expand. This is done by inserting a needle and syringe (if the pneumothorax is small) or chest tube through the chest wall. This allows the air to escape without allowing any air back in. The lung will then re-expand itself within a few days. Surgery may be needed for repeat occurrences. Most people recover fully from spontaneous pneumothorax. Up to half of patients with spontaneous pneumothorax experience recurrence. Recovery from a collapsed lung generally takes one to two weeks. Tension pneumothorax can cause death rapidly due to inadequate heart output or insufficient blood oxygen (hypoxemia), and must be treated as a medical emergency. Refer http://medical-dictionary.thefreedictionary.com/Punctured+lung for more info. Best

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