Worsening Course

EMS delivered our umpteenth (surprise!) no-helmet motorcyclist of the summer last night.  He sustained fairly minor road rash and a small forehead hematoma after a low-speed collision with a guardrail.  He arrived alert, but slightly confused, and joked with the staff throughout the trauma assessment.  At first glance he looked like he just might be able to walk out with a reasonably speedy dispo.

As he waited for the previous trauma patient to get off the CT table, however, he began to complain of a new-onset headache.  While I was hooking him back up to the monitor after his scan, he started feeling nauseous.  Waiting for the read on the CT, his confusion worsened and he soon started vomiting.  

Survey says brain bleed, as confirmed by the scan.  Instead of cruising off to that BBQ, he was admitted to an ICU bed.

Just wear a helmet.  Please.