Initial Intervention:

   The patient was intubated by the airway doctor to protect the airway and to allow delivery of 100% Oxygen. An Oro-gastric tube was passed at the same time.
   A Left Chest drain was inserted by the surgical registrar. It drained 200mls of frank blood. A CXR was obtained post-insertion, which revealed extensive left lung contusion and a small residual pneumothorax. (See CXR).

00:50 - Despite these interventions the patient is still only saturating at 88%! There are no new chest findings.

   Would you accept that saturation on the basis of decreased peripheral perfusion and move onto fluid resucitation and haemorrhage control?

What happened next: Page 3

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