A patient who changed my practice: Always check the respiratory rate

The young lad had been injured riding a motorbike “off road.” He was complaining of lower chest pain and had tenderness suggestive of blunt injury but with no obviously fractured ribs. His pulse and blood pressure were normal but he was breathing at 40 per minute. A drip was put up and he was sent to have an x ray examination. While being transferred to the trolley his blood pressure dropped and he became unconscious. He was rushed back to the resuscitation room and what had seemed to be a controlled …