That's my sloth face. It happens whenever I do some research on PuffHo or the DailyKok.

Okay guys, I like the way you're thinking.

Brush ... I like the Narcan call. 2mm pupils and slow shallow breathing. Only one thing, would you want to push the full 2mg at once, or space it out 0.4mg (x's 5) or 0.5mg (x's 4)? If you hit him with the full 2.0mg, you might run the risk of completely waking him up. Thinking about spacing out the dosage over time, just enough to bring up his respirations, might be something to consider.

Trapper ... Good call on the Dextran/NS and treatment plan. This guy definitely has some major trauma to deal with.

Bandaid ... I like the call about securing the weapon in a paper bag. As Brush mentioned, the normal route for dealing with a weapon on scene, is letting PD handle it, but in this scenario, PD isn't available to do so, and of course, we wouldn't want to leave it laying around, and as you said, it is evidence.

PediDoc ... You're welcome. :D These are cool to do, and getting everyone else's POV and treatment plan.

Now here's something for everyone ....

Yes we do have a weapon found with the Pt., and a bag of "Potpourri", presumably drugs, but go back and take a look at the photo, and look closely at the wound where the Pts. nipple is supposed to be, and look just laterally of that wound at where the "exit" wound begins.

Remember, it is a "Stormy and rainy" night. ;) :munchin

Oh wow, this is a lightning strike? :munchin

Yup :cool: I'm wondering if this guy was wearing a shoulder holster and the gun was the conductor?

Good one SDiver!:lifter I initially thought the "charring" of tissue was necrotic tissue from the GSW and the "charring" around the "entrance wound" were "powder burns". Totally consistent with a lightning strike. This guy was some kinda lucky. If he wasn't carrying he'd be dead at the scene.

Was the gun even fired?

Thanks for throwing us the huge bone, Sdiver.

Was a nipple ring, bychance, the conductor? :confused:

Yep !!!!! ..... It was either a nipple ring or stud or something definitely metallic that was the conductor.

The gun, was never fired or used. He just carried it in his left inside jacket pocket (sorry Trap, no shoulder holster. :) it was just loosely carried in there). It just happened to fall out and land underneath him after he got struck by the lightning.

People see/read about the gun and that type of wound and immediately think GSW, when in fact, lightning hit the nipple ring/stud and exited out his side, striking the gun in his jacket pocket. None of the rounds in the gun were discharged or went off, in fact the gun was wholly intact, that cavitation was caused just by the lighting alone.

Thanks for playing folks .... we have some nice parting gifts for ya. :lifter

;)

Now WTF would I do with a nipple ring? :p

This was fun SDiver. Can we do it again, huh? Can we? Can we?

Okie, not sharpshooting here, but delivering narcan in a GSW case just to relieve respiratory depression (which, from the vitals and pt's mental status suggest that intubation would be no problem) seems counter intuitive due to the fact that when this guy does come around, you've filled up his opiate receptors with NARCAN and now you've increased the mental and physical trauma this guy is going to get. Now, as a military medic I don't see the drug OD as much, but is this the typical treatment for such a patient in a pre-hospital setting?

Sdiver, what website do you get these off of? I took this scenario into my aid station today to see what some of the other medics thought and they enjoyed it thoroughly.

I'm not a medical professional but I do enjoy reading these scenarios.

Don't know if it matters, but is it possible that he was smoking the potpourri (the kids call it spice). I have a friend whose son had a stroke smoking that shit. Maybe that's why he was wandering around in a rain storm. Several stores around Fort Lee are of limits because of it.

Unknown if this is what happened, but it most likely is.
"Spice" and now "Bath Salts" are showing up with more frequency and is something that we're having to train up on, on how to handle and it's turing out to be some scary ass shit.

Awwww Man ...... A good fisherman never tells others where his good fishing holes are, that is, until he's ready to hang up his fishing pole. :D