The call was simple when it came in, a man has fallen and is bleeding.

As you climb the granite steps, they are narrow and steep and so far each one is covered in spots of bright red blood.  As you step carefully around the spots and up to the third switch back you find your patient standing in the corner, head laceration over the right eye, slurred speech and a wicked flail chest.  He’s 83.

He’s grasping onto the railings at a turn in the stairs, barely enough room for you to pass by and survey from above.

Similar to this photo from a hotel somewhere, the fellow with the red spot on his face is your patient, just imagine him standing straight up in the corner.  The stairs down around the corner are just as steep and narrow as the stairs here.

How will you deal with C-Spine precautions, if at all?

You make the call.

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