Thread: GSW to chest
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Old 01-25-2009, 12:31   #3
x SF med
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Initial thoughts from pic and stats:
BP is low due to loss.
Minimal involvement of pulmonary and cardiac systems - SO2 still good, HR still good.
Based on photos - bleeding is well under initial control - internal loss hard to determine.
Looks as though a single large bore is set on non affected side - clear fluids - therefore a second needs set, for packed cells if available, and SO2 reduces.
concerns based on the 2 visible entry wounds - Humeral and shoulder involvement - possibly brachial nerve, artery and vein involvement.
Proximity to pulmonary cavity gives rise to throbocytic secondary involvement.
Initial films - full upper thoracic and L extremity series (ortho involvement, location of projectiles)
Start GSW ABX therapy as proescribed by local guidelines (not sure if this is civ or Mil)
Labs - CBC, Tox, SO2, Sed
Currnt concerns are pulmonary involvement with traumatic/projectile tamponade - same for major vessel involvement. Ortho involvement in both shoulder and upper L extremity.

without seeing and touching it's a tough call.
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