Q. You found that to be normal?
A. Correct.
Q. The next thing you did was check for pulse and
bruitt?
A. Just pulse.
Q. Let's start with the right, the peripheral carotid,
you listed as two plus.
A. Yes.
Q. Is that within normal limits?
A. Yes, that's normal.
Q. The bracial pulse is two plus. Within normal
limits?
A. Yes.
Q. The radial pulse is two plus. Within normal
limits?
A. Yes.
Q. Femoral pulse, two plus. Within normal limits?
A. Yes.
Q. I see there is no popliteal pulse, either right or
left. Do you know why that is?
A. It's very difficult to feel, and if the pulses can
be palpated distally then it's usually present.
Q. There is two plus for dorsalis pedis?
A. Right.
Q. That was within normal limits as far as you were
concerned?
A. Yes.
Q. And two plus tibial?
A. Posterial tibial.
Q. On the right, and the readings were all the same on
the left of two plus?
A. Correct.
Q. As far as you were concerned, his peripheral pulses
were all within normal limits?
A. Yes.
Q. You then checked his spine and you checked off
normal. How did you examine his spine at that time?
A. By palpation.
Q. In doing that, did you have to turn him over?
A. No, you put your hand underneath him.
Q. You examined his abdomen and by inspection you
saying normal you have circled the word "flat," am I correct?
A. Yes.
Q. And written the word "nontender." Is that on
inspection or is that under the palpation portion?
A. That's palpation.
Q. The fact that he had a flat abdomen was a normal
sign?
A. Yes.
Q. You then palpated his abdomen?
A. Yes.
Q. And found it to be nontender?
A. Correct.
Q. Do I conclude from that that your inspection of his
abdomen by palpation was normal?
A. Yes.
Q. You then did percussion of the abdomen?
A. Yes.
Q. What were your findings?
A. It was normal.
Q. You did auscultation?
A. Yes.
Q. What were your findings?
A. Normal.
Q. Then did an examination of the genitalia?
A. Yes.
Q. And found that to be normal as well?
A. Normal.
Q. Did you do a rectal examination?
A. I probably was not the one that physically did it,
but it was done in my presence.
Q. And found to be normal?
A. Yes.
Q. Under stool, there is something that I can't read.
A. Hem negative, meaning there was no blood in the
schools.
Q. Under "extremities," it is written normal and you
have checked as what?
A. No obvious bony deformity.
Q. How did you examine the extremities?
A. By inspection and palpation. He had no obvious
fractures.
Q. The joints you have checked as normal. What joints
would it be that you checked at that time?
A. Also extremities.
Q. Did you check for meningeal signs?
A. No. You are not allowed to move the neck in a
trauma patient.
Q. Would you describe for me how the neurological
examination that you performed on this first examination that
you did?
A. Neurological exam, he was awake and oriented.
Q. Excuse me? I'm sorry. I didn't mean to interrupt
you. Tell me first what you did and then we will get to the
results.
A. What I did was examination and by how he was
answering questions, I evaluated his responsiveness.
Q. Did you do at this time any pinprick tests?
A. No.
Q. Or any objective tests of that nature?
A. No. This is also a primary survey, quick and
brief.
Q. So you wouldn't have been hitting him with hammers
or anything like that?
A. No.
Q. Neurological, would you read for me what you have
written under that section?
A. Awake, oriented to name only, combative, confused,
moving all four extremities strongly and answers questions
appropriately.
Q. When you say that he was oriented to name only,
what was he not oriented to?
A. To where he was and when it was.
Q. How did you elicit that he was not oriented to
those things?
A. He did not know where he was. He did not realize
he was in the hospital.
Q. What was the significance to you of his moving all
four extremities strongly?
A. He showed no focal signs of neurological deficits.
Q. Other than what you have told me about what you
have asked him, when you wrote "answers questions
appropriately," is it those questions that you have already
told me about?
A. Yes.
Q. During this part of the exam, did you ask him
something else?
A. Those questions that I asked him initially.
Q. His speech you checked was normal?
A. Yes.
Q. Cranial nerves; how did you examine the cranial
nerves at this time?
A. That's also a very brief inspection of the face and
how he moves his face in conversation.
Q. Is that at the end of the physical examination that
you did?
A. Yes.
Q. You wrote an impression. Would you read that for
me, please?
A. "18 year old, Hispanic male in high speed on--in
high speed head on collision. Rule out closed head injury."
Q. The next thing on this list or plan is diagnostic.
The blood work that was drawn at the time of this examination
generally speaking, how long would it take for that to come
back so that it appears on your initial examination sheets?
A. The blood gas comes back first. That's usually
within ten, fifteen minutes. The rest of it takes at least
an hour.
Q. Now, can you, starting with the top line under
bloods, with the 138, tell me what the number represents,
that is, what test is it and then tell me whether it's high
or low or within normal limits?
A. The sodium was 138. That was normal. Potassium
was 3.7. That was normal.