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Old 01-25-2009, 11:46   #1
Doc Dutch
Trauma Surgeon
 
Join Date: Sep 2007
Posts: 83
GSW to chest

Okay team, it is 2:30 am and you are on-call and you are called by the patch phone that a 19 year old male is coming in with two GSW's and one is to the posterior left chest. They report they are 5 minutes away and coming in hot . . . Vitals BP 108/55, HR 105 to 110, RR 20 (isn't everybody's on the flowsheets?) and the SaO2 are 100% on 100% no-rebreather. He is alert and his GCS is 15 moving all extremities. The patient arrives and here is an attachment. Excluded his face so no one can recognize him but did not take away any of the pertinent physical findings.

Okay, thoughts?

1) What does this represent to you in terms of the GSW?
2) What studies would you get? (Labs, Films,etc)
3) What would you look for on physical exam?
4) How would you treat this injury initially?
5) What organs are you worried about or none at all which gets back to what studies and how you are going to treat this?

I will give you more as answers come in. Good teaching case to run through the drill of patient care and ATLS . . .

D-
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