Fall from 10 meters high, what happens next?

Abstract text (incl. references and figure legends)

Female, 26YO. Suicide attempt witnessed by civilians: fall from about 10 meters high. Found on the public road in prone position. Upon admission to the emergency room, the airway was patent and permeable, with tachypnea and decreased breath sounds bilateral. Tachycardia with hypotension. Cold ends. GCS of 14, with iscochoric pupils. No hip instability. Deformity of the right humerus and left femur.Chest x-ray:left pneumothorax + bilateral contusion. A 30Fr drain on left hemithorax was placed with the exit of air and some blood.After 10 min of being in the emergency room, her neurological status worsens–GCS 9.Intubation and invasive ventilation was done. Performed TC-TAP: thoracic trauma: fracture of the 1st left costal arch + bilateral pneumothorax + bilateral pulmonary contusions- Abdominal trauma: traces of left kidney fracture- limb trauma: fracture of the right humerus (immobilized with plaster), fracture of the left femur (immobilized for deferred surgical treatment)- spinal trauma: C1 anterior arch+ C4 right lamina+ D12+ dorsal and lumbar left transverse apophyses fractures, L2+ sacral fractures of the left iliopubic branch. Admission to the Intensive Care Unit.She remained hospitalized for 56 days, during which she was operated on by orthopedics for surgical treatment of spinal, femur and humerus injuries. She remained intubated and ventilated for 30 days because of a ventilator-associated pneumonia. She was successfully extubated, and was discharged from intensive care on the 35th day.She was diagnosed with ASIA A vertebromedullary injury.On the 56th day,due to abdominal pain, a TC was performed: pneumoperitoneum due to perforation of the cecum. She was operated: ileocolic resection, terminal ileostomy and lateral transverse colostomy. She keeps doing her fisical rehabilitation on our hospital, waiting for a vacancy in a specialized rehabilitation center. References: ATLS, 9Th Edition, ACS; DSTC, 5th edition, IATSIC.

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