Rick: Trapped Crush Trauma, Depressed Skull Fracture, Burr Holes, and Craniotomy

Rick's condition has moved beyond field bandaging. The episode frames emergency skull decompression as a bridge until he can be transported for definitive brain surgery.

Rick is documented in the episode medical notes with diagnosis: Chest injuries, Leg injuries, Broken arm, Crush injuries, Blown pupil, Seizure, Depressed skull fracture, Intracranial bleed. Treatment listed for the case includes Burr holes, Craniotomy. *Diagnosis: **Chest injuries **Leg injuries **Broken arm **Crush injuries **Blown pupil **Seizure **Depressed skull fracture **Intracranial bleed *Doctors: **Richard Webber (general surgeon) **Unnamed neurosurgeon **Mark Sloan (plastic surgeon) **Izzie Stevens (surgical intern) *Treatment: **Burr holes **Craniotomy Rick was still seizing and still trapped under the car. Needing assistance, Izzie called the hospital for help. Webber talked her through drilling burr holes over the phone with Mark's help. Once she drilled a hole, she looked at the dura, which was pulsing with his heart beat. Then she packed the area with gauze to minimize bleeding and they waited for him to be extracted. While they were waiting, he opened his eyes. He was then transported to the hospital so he could have brain surgery.

Trapped Crush Trauma, Depressed Skull Fracture, Burr Holes, and Craniotomy

A real team would manage airway and seizure risk, maintain spine precautions, reassess pupils and neurologic status, obtain CT after extrication, and coordinate neurosurgical intervention.

Management may include airway support, antiseizure medication, emergent decompression in selected settings, transport, craniotomy, and ICU monitoring.