Quote:
Originally Posted by Brush Okie
TX:
O2 high flow
C Spine
IV NS x 2 en route use at least one blood Y
Rapid transport via ground to nearest trauma center. (if MD is on helo might go that way.)
Possible chest decompression and or chest tube depending on scope of practice as warranted by Sx ie JVD tracheal deviation, decreasing lung sounds etc etc
Pt may have spinal injury and or neurological shock. Also possible hypovolemic shock. Possible hemo/pnumo thorax.
Pt lost conciseness and abrasions on head so possible closed head injury or possible pellet in head/brain. (I'v seen bullets do weird and unpredictable things)
Long story short this guy needs a surgeon ASAP and at best in the field you might be able to relieve a chest hemo and or pnumo thorax to buy him some time.
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Someone said "need a surgeon"......... 
great case, no helo and what is the transporting person going to do if
1) paramedic level?
2) EMT-I or B
Cant say possible, what are you going to definitely do
think it through...
__________________
'Revel in action, translate perceptions into instant judgements, and these into actions that are irrevocable, monumentous and dreadful - all this with lightning speed, in conditions of great stress and in an environment of high tension:what is expected of "us" is the impossible, yet we deliver just that.
(adapted from: Sherwin B. Nuland, MD, surgeon and author: The Wisdom of the Body, 1997 )
Education is the anti-ignorance we all need to better treat our patients. ss, 2008.
The blade is so sharp that the incision is perfect. They don't realize they've been cut until they're out of the fight: A Surgeon Warrior. I use a knife to defend life and to save it. ss (aka traumadoc)
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