Quote:
Originally posted by swatsurgeon
new case for management...allow me some liberties in the story.
soldier hit in right arm by 7.62/.308 round. No armor covering this area, just long sleeves on BDUs. Entrance from his right side.
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LOC ...AVPU
Airway, Open and Clear
Breathing, RRQ
Circulation--Radial Pulses? CRT's? Skin Characteristics?
Major bleeding controlled?
Rapid head to toe Trauma ASSMT.
Load and Go due to MOI of GSW.
Secondary survey to make sure I didnt miss anything on the head to toe.
DX-GSW to RT humerus at the proximal end of extremity. Entrance wound on the posterior with an exit on the anterior side of arm.
TX--Dress with moist sterile dressings, Immobilize as best as I can.
Hang 2 16-18 G IV NS run them wide open to keep Systolic above 100mm/hg as I know he is going to be shocky.
O2 Therapy 15 l/min NRB.
Pain Mgmt with 8-10 MS IV push with 12.5 of Phenegran for nausea.
Call for EVAC ...he is going to need a surgeon if there is any chance of saving his arm.
Jason