Quote:
Originally Posted by linedoc
On a further note, a little past my echelon but what are the chances of someone coming back from an initial GCS of say 3 or 4? Also, what are some key Tx to help this type of PT down the road? My gut tells me chances are not so good, but I am curious.
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I have my GCS right in front of me and I'm getting more info directly from a trauma nurse sitting right beside me at the moment. Great guy!
I can say that in
my experience of the casualties I've dealt with having a score of 3 to 4, the prognosis of survival was not good. At this level they don't even withdraw from pain...say a deep fingernail/toenail-bed roll with a pen...between 5 and 7 I've seen withdrawal from pain, and the survivability was increased, but everything is going to be scenario and injury based as well as how quickly can you get them to an advanced care facility?
The trauma nurse is saying that at a score of 5 or less intubate immediately. Usually they will expire within a matter of hours or days, at a 3 or 4, depending on the expertise of the medical team taking care in ICU, etc. Hours or days.
Everyone's physiology is so different and with the LN's they're already so dehydrated and under nourished, etc. they go into shock a whole lot faster than one of us would from a comperable wound(s).
I dealt with a strangulation case not too long ago...No pulse, had to intubate immediately, pink frothy sputum coming out the combi., and this guy was at a
3. NO RESPONSE whatsoever. I don't remember what the SPO2 was, just that it was way too low for a live person. We performed all the right steps immedately beginning CPR, all the way to the hospital which took all of 5 minutes. If you've ever been to Bucca, you'll understand. I personally performed chest compressions on this guy for at least six or seven minutes before handing off to trade places and bvm.
Short of it, 20 minutes later after numerous meds and three compression switchoffs, the Doc called it. Strangulation was his only injury too. Multiple injuries complicate things way off the charts.
Beyond that, I'll wait for someone else with more experience and expertise to put their .02 in because I don't want to sound like a know-it-all here.
Little help here, guys.