Case Study 7: Melbourne to Toowoomba

The Alfred Hospital Melbourne to Toowoomba Queensland

A 27-year-old male working in the transportation industry on February 22, 2012 was involved in a high-speed motor vehicle accident resulting with the truck running off road, rolling and bursting into fire.

The patient was ejected out of the cabin and found at the scene with an altered glasgow coma scale and multiple lacerations and was airlifted to The Alfred Trauma Centre. A CT-brain, spine, chest and abdominal scans, showed a large left frontal subgaleal hematoma with a complex scalp laceration, C5 kyphosis, mild atelectasis at lunge base blunting of costophrenic angles, small pleural effusion, fractures to ribs 5-9 of left anterior. Other injuries included left deep lateral leg wounds and multiple bruising and graze to trunk and limbs.

Other significantly comorbidities contributed to medical recovery including morbid obesity with a mass of 188kg, type two respiratory failure on nocturnal CPAP and warfarinised for previous pulmonary embolism.

His high anesthetic risk precluded theater resulting in delays to wash out his wounds, debridement and closure.  He was admitted to intensive care type with type two respiratory failure.

On March 3, his left leg laceration was debrided, however, at this point it had became infected with pseudomonas. On March 8, he underwent further debridement and split skin graft from left upper thigh to left lower leg to close the wound.

An aeromedical risk assessment was completed and on March 15, 2012  and he was successfully repatriated back by Medical Connect to Toowoomba Queensland, by air and road.