Brittany is unconscious when the paramedics arrive, but as they begin to put her into a hard neck collar, strap her to a firm board and carefully place padding around her; she starts to drift in and out of consciousness. She is also bleeding from a large gash above her eye. In the ambulance, the paramedic monitors her vital signs — she is hypotensive and her pupils are unevenly dilated. The paramedic has placed Brittany’s wallet on the gurney and a policeman retrieves her driver’s license.


The mother from the other car is placed in another ambulance and keeps asking for her daughter. The policemen cannot find anyone else in the car and think she must be confused. Then she remembers she already dropped off her daughter at school and starts crying with a mixture of relief and pain.


Once in the hospital emergency department (ED), the admitting clerk types “Brittany Wilson” into the computer and pulls up her electronic health record (EHR). The policeman confirms her contact information and leaves to locate her parents. The triage nurse has already confirmed that Brittany must be immediately placed in a room and a team of healthcare professionals are beginning to assess Brittany’s injuries.


  1. Internet Research: The paramedics are very careful while placing the neck collar on Brittany, strapping her to a firm board and placing padding around her. Why are they being so careful?


  2. Internet Research: Brittany was unconscious for approximately 30 minutes and has been drifting in and out of consciousness since arriving at the hospital. What are the levels of brain injury that determine the severity of her injury?


  3. Internet Research: The triage nurse uses the Glasgow Coma Scale and determines Brittany’s score to be a nine. How serious is her injury?

    Internet Research: What are the three categories graded by the Glasgow Coma Scale?