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Hmm.. well after he has evaluated for ABC’s and further injury, splint in neutral position, vascular and neuro checks, maybe MS4 2-15mg’s titrated, a gram of Ancef IV, evac to a tertiary facility and hope there is good ortho and possibly vascular surgeon available. The direction of the object makes me wonder about some neuro involvement. What to do if you can’t evacuate in a timely (like a month or two) manner. Pull it out and control the bleeding. Antibiotics and pain meds and hope for the best.
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