List Archives

Thu, 28 Mar 2002 16:29:29 +0000

>PS some will not be happy with a 3 liter resuscitation while standing 
>around.

Some of us would be extremely UNHAPPY with a 3L resus in this situation.

Fiona Wallace
(Soon-to-be registrar ED, Galway.)

>Marcos Reis wrote:
>
>>     This is a very interesting recent case and I'd like to know the 
>>opinion of the Surgeons of the List. At the end I can send the photos if 
>>anybody wants.
>>
>>     A 19 years old male patient entered in the ER  last monday ( 
>>2002/03/28 ), in shock, with 2 gunshot wounds  ( 10-20 min before 
>>admission ); one gunshot wound in the LEFT posterior axilar line ( 9th 
>>intercostal space ) and another gunshot wound in the left upper abdominal 
>>quadrant. No exit wounds . Vital signs: BP 70/30, P 140, RR 32, GCS 14. 
>>The auscultation revealed breath sounds decreased  on the RIGHT hemithorax 
>>and he had abdominal pain. We obtained a  chest film that demonstrated the 
>>bullet in the RIGHT hemithorax and fluid/blood density  all over the RIGHT 
>>side, nothing wrong was seen at the LEFT hemithorax and there was NO 
>>widened mediastinum .  The abdominal film ( AP ) demonstrated a bullet in 
>>the projection of  L4. After rapid administration of 3000ml of IV fluids ( 
>>Ringer ) there was no increase in his blood pressure and the patient was 
>>sent to the operation room. Clear yellow urine was obtained at the urinary 
>>catheter .
>>
>>     What would you do?
>>
>>
>>
>>     Marcos Reis,  MD  Trauma Surgeon
>>
>>     Jo�o XXII Hospital - Trauma Center - Belo Horizonte, Brazil
>>
>

_________________________________________________________________
MSN Photos is the easiest way to share and print your photos: 
http://photos.msn.com/support/worldwide.aspx

List Archives

For your convenience, find the Trauma List Archive Below

A new interesting case for you...