1. Step 6
1.1. Review session 1
1.1.1. Summary of step 5
1.2. Report new knowledge
1.2.1. guidelines to motorbike accidents and what to do as first
1.2.1.1. ABCDE
1.2.1.2. head to toe examination
1.2.1.3. AMPLE
1.2.2. vital signs changes after traumas
1.2.2.1. bleeding (4 classes)
1.2.2.1.1. thigh injury (type 4)
1.2.2.2. hypovolemia
1.2.2.3. blood pressure and shock
1.2.2.4. cardiac output
1.2.2.5. respiratory rate
1.2.2.6. PH
1.2.3. thigh structure and injuries
1.2.4. effect of alcohol on driving and traumas
2. Step 7
2.1. Inquiry plan and info gathering
2.1.1. History of presenting complain
2.1.2. Previous medical / surgical history
2.1.3. Drug history / allergy
2.1.4. Family history
2.1.5. Social / occupational history
2.1.6. Physical examination
2.1.6.1. close femur fracture
2.1.6.1.1. midshaft fracture
2.1.6.1.2. completely displacement
2.1.7. tests results
2.1.7.1. low PH
2.1.7.2. low PCO2
2.1.7.3. low HCO3
2.1.7.4. high O2
2.1.7.5. normal hemoglobin
3. Step 8
3.1. Diagnostic decision
3.1.1. midshaft femur fracture causing hypovlolemic shock
3.2. Mechanism
3.2.1. trauma (ATV) in a rainy day when he was under effect of alcohol.
3.3. Presentation
3.3.1. hypovolemic shock
3.3.2. right thigh deformity
3.4. Supporting data
3.4.1. x-rays showed complete displacemet and right midshaft femur fracture
3.4.2. low PH
3.4.3. abnormal vital signs