Mr. Hutchinson, another middle-aged victim of the collision on Route 91, has a tourniquet around his thigh when admitted in an unconscious state to Noble Hospital. The emergency technician who brings him in states that his right lower limb was pinned beneath the bus for at least 30 minutes. He is immediately scheduled for surgery. Admission notes include the following:
Multiple contusions of lower limbs
Compound fracture of the right tibia; bone ends covered with sterile gauze
Right leg blanched and cold, no pulse
Blood pressure 90/48; pulse 140/min and thready; patient diaphoretic (sweaty)
Will the fracture be attended to, or will Mr. Hutchinson’s other homeostatic needs take precedence? Explain your answer choice and predict his surgical treatment.
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