From the Research
The initial treatment approach for patients presenting to urgent care after a motor vehicle accident (MVA) should prioritize systematic assessment and stabilization following trauma protocols, focusing on the ABCs (airway, breathing, circulation) to identify and address life-threatening injuries, as recommended by the most recent and highest quality study 1. The treatment approach should begin with a thorough physical examination, focusing on areas of pain, visible injuries, and neurological status.
- Key aspects of the initial assessment include:
- Airway management: ensuring a patent airway and considering spinal immobilization to prevent further injury 2.
- Breathing and circulation: evaluating respiratory and cardiovascular status, and providing supplemental oxygen as needed.
- Disability and exposure: assessing neurological function and exposing the patient to evaluate for other injuries. Appropriate imaging should be ordered based on clinical findings, typically including X-rays for suspected fractures and CT scans for potential head, neck, or internal injuries.
- Pain management is also crucial and may involve:
- Acetaminophen 650-1000mg every 6 hours or ibuprofen 400-600mg every 6-8 hours for mild to moderate pain.
- Stronger options like tramadol 50-100mg every 6 hours for severe pain.
- Muscle relaxants such as cyclobenzaprine 5-10mg three times daily may help with muscle spasms. It is essential to document all injuries meticulously, as this information is crucial for both medical follow-up and insurance purposes.
- Patient education should include warning signs requiring immediate return, such as worsening pain, neurological changes, or new symptoms, and appropriate follow-up arrangements should be made with primary care or specialists depending on injury type 1. This comprehensive approach addresses immediate concerns while establishing a foundation for ongoing care and recovery, ultimately prioritizing morbidity, mortality, and quality of life as the outcome.