You are working at *rural* Clerkship General when you receive a radio call from EMS – 7yo male from a severe bus accident with a large scalp laceration, unable to control the hemorrhage.

Initial Vitals

  • HR: 136
  • RR: 22
  • BP: 80/35
  • O2%: 100%
  • Temp: 98F

Critical Actions:

  • Perform ATLS Algorithm
  • Control Hemorrhage
  • Transfuse pRBCs
  • Replete Factor VIII with correct dosing (100% replacement)
  • Diagnose supracondylar fracture on XR and splint appropriately

Further Reading:

emDOCs – Managing Hemophilia in the ED

CoreEM – Supracondylar fracture in the ED