The company transported an unconscious construction worker, who fell off the roof of a two-story building, to the hospital. Which clinical finding would the nurse report immediately?

Traumatic brain injury from a high-altitude fall can result in a basilar skull fracture, involving the petrous portion of the temporal bone. This fracture allows the escape of cerebrospinal fluid or blood through the auditory canal, posing an immediate risk of meningitis and indicating significant intracranial pressure changes or structural brain damage. Rationale: A. Vesicular breath sounds represent normal, soft, low-pitched sounds heard over most of the lung parenchyma. This is an expected finding indicating adequate ventilation and absence of consolidated tissue. It would not require immediate reporting as it signifies a stable respiratory status in that lobe. B. While a fever can occur due to hypothalamic injury or infection, it is usually not the most acute priority post-trauma. An isolated temperature increase is less life-threatening than active hemorrhage. Immediate reporting focuses on neurological or circulatory collapse following a significant mechanical fall. C. Bilaterally reactive pupils indicate that the oculomotor nerve and brainstem pathways are currently intact and functioning. This is a reassuring clinical sign in an unconscious patient. It suggests there is no immediate unilateral compression causing pupillary dilation or a fixed, non-reactive state. D. Otorrhea or bleeding from the external auditory canal following head trauma strongly suggests a basilar skull fracture. This is a critical finding that must be reported to prevent herniation. It indicates potential dural tearing and requires urgent neurosurgical evaluation to manage potential complications.