Finding into death of Pauline Mary Riordan
Deceased
Pauline Mary Riordan
Demographics
61y, female
Date of death
2013-12-23
Finding date
2019-01-31
Cause of death
injuries sustained in a motor vehicle collision as a passenger
AI-generated summary
A 61-year-old woman died from hypovolaemic shock and cardiac arrest following a motor vehicle collision in rural Victoria. She was trapped in her vehicle for approximately 90 minutes with severe crush injuries and lower limb entrapment. While paramedics provided appropriate field care including fluids and analgesia, the extended extrication time delayed definitive treatment including blood transfusion available only at hospital. Expert evidence indicated that earlier extraction might have improved outcomes, though earlier extraction would not have definitively prevented death. The emergency response system functioned appropriately. Road rescue personnel made reasonable decisions about extrication methods. Key lessons include the need for rapid transport of trauma patients to centres with transfusion capability and potential benefits of pre-hospital blood products, tourniquets, and improved communication between trauma specialists and paramedics in regional areas.
AI-generated summary and tagging — may contain inaccuracies; refer to original finding for legal purposes.
Error types
Drugs involved
Clinical conditions
Contributing factors
- crush injuries with significant entrapment
- prolonged extrication time of approximately 90 minutes
- hypovolaemic shock from uncontrolled lower limb bleeding
- limited intravenous access and inability to administer blood products in field
- rural location limiting access to tertiary trauma centre with transfusion capability
- crush syndrome and tamponade effect of dashboard
Coroner's recommendations
- Efforts by health services, trauma centres and the Department of Health and Human Services to improve pre-hospital care of trauma patients through: availability of tourniquets to paramedics to stem bleeding (now available), development and availability of synthetic blood products for field use, supported real-time clinical decision-making tools and/or direct communication between trauma experts and paramedics in the field
- Consideration of blood transfusion availability to Ambulance Victoria paramedics for regional trauma patients
- Improved communication pathways between trauma clinicians and pre-hospital paramedics in regional areas
Full text
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