A
horse rider falls at a jump and sustains a closed head injury without
impairment of
consciousness
at any stage and a femoral shaft fracture, which is internally
fixated
with
an
intramedullary nail soon after admission. At 48 hours post-injury she
becomes
confused,
tachypnoeic, hypoxaemic and pyrexial (38.2 °C). An atypical rash is
also
noted.
Which one of the following statements is MOST APPROPRIATE?
a)
Immediately alert the orthopaedic surgeons
b)
Based on these features, anticoagulation is indicated
c)
Transfusion of packed red cells is indicated
d)
A chest X-ray will contribute to resolving the situation
e)
An urgent CT head scan is highest priority
