HomeAnswersInternal Medicineroad traffic accidentsWhat could be the possible cause of bleeding from the mouth after a road traffic accident?

My brother-in-law has chest and back pain and is bleeding from the mouth after RTA. Why?

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The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

Medically reviewed by

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Published At September 8, 2021
Reviewed AtSeptember 8, 2021

Patient's Query

Hello doctor,

My brother-in-law met with a motorcycle accident. He did not wear a helmet.

He complains of backache, chest pain, difficulty in breathing, and bleeding from the mouth. I have attached his x-ray.

Kindly help me know if I can transfer him to a private hospital now.

Thanks.

Hello,

Welcome to icliniq.com.

I am very sorry for the injury sustained to your brother-in-law.

How is he now? What about his vitals, heart rate, blood pressure, respiratory rate, GCS score (Glasgow coma scale)?

The history and symptoms you have mentioned need hospital admission, doctor treatment, and supervision without any delay.

The x-ay you have sent is unclear (attachments removed to protect the patient’s identity). However, there is more blackening over the left lung field, suggesting potential pneumothorax injury. This could be the reason for the difficulty in breathing. If there is trauma over the anterior chest wall in the accident, it will make breathing difficult.

There is no gas under the right diaphragm hence no injury to the peritoneum. Bleeding from the mouth could be due to a local injury around the oral cavity or internal bleeding. If there is internal bleeding, the patient will be hemodynamically unstable. He will have low blood pressure and an increased pulse rate.

He should undergo eFAST (extended Focussed Assessment Sonography for Trauma) to assess any suspected internal bleeding. Other measures should also be taken. Proper guiding would be possible with more information on the injury sustained.

The best to be done is to visit an emergency room in a local hospital and let the doctor proceed with the examinations and treatment accordingly.

I pray for his recovery and hope he has sustained a minor injury.

I hope this helps you.

Thanks.

Patient's Query

Hello doctor,

Thank you for the response.

My brother-in-law and his cousin were injured in the Road accident. We paid for a private hospital this morning. After two nights, they only received first aid, x-rays, Dextrose, antitetanus and were not sure about antibiotics. But they are delaying the treatment saying to undergo a COVID test first before admission.

He is still in a small clinic in the village due to the bureaucracy of transfer documents, discharge documents, and COVID tests. I know I did not give enough details, but that is all I have at the moment.

Kindly help me know what could be done next to ensure him to be in safe hands.

Thanks.

Hello,

Welcome back to icliniq.com.

I saw the picture (attachments removed to protect the patient’s identity).

I feel very sorry about this.

One of the guys (probably cousin as you are referring) is severely injured in the head region with swelling of the face, eyes, and oral cavity.

Another guy that is your brother-in-law also has a head injury with eye swelling, blackening, and many abrasions on the skin, peripheral injuries, blood loss, etc.,

In the case of road traffic accidents (RTA) multiple injuries happen. In their case, head trauma is also present, and the rest of the injuries that is a fracture, internal injury, etc., cannot be seen in the picture.

Both need urgent hospital admission and supervision of the doctor.

The patient's hemodynamic status, that is, blood pressure, pulse rate, respiratory rate, GCS score, etc., is essential in the outcome of the patient.

Important investigations like CT (computed tomography) scan of the brain, neurological assessment, and intervention are needed.

The valuable guidance I can give online is urgent hospital admission. The attending doctor will assess the severity of the injury and provide a multidisciplinary approach to stabilize the condition. Various investigations have to be done along with treatment to know the prognosis of the condition.

So, the attending doctor is the ideal person to give the correct status and prognosis of the health.

I hope it gives you some guidance.

Take care.

Let energy be with them.

Thanks.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Basuki Nath Bhagat
Dr. Basuki Nath Bhagat

Family Physician

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