unique penetrating injury

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Was the x-ray, showing the "minimal hemothorax" in the  right side, done
after the chest tube insertion? If so, how much did it drained initially?

Gustavo E. Flores Bauer, MS4 EMT-P :.
e.mail: gflores at emergencyteam.net
web: www.emergencyteam.net
cel: 829-770-0707
 
"My karma ran over your dogma."
 

-----Original Message-----
From: trauma-list-bounces at trauma.org [mailto:trauma-list-bounces at trauma.org]
On Behalf Of SJASMD at aol.com
Sent: Saturday, August 11, 2007 11:01 AM
To: trauma-list at trauma.org
Subject: unique penetrating injury

A 37 YO man is brought in by EMS after sustaining multiple gunshot wounds.
He 
has a GCS of 7 with a possible blown pupil, absent right breath sounds,
blood 
in his mouth and adequate blood pressure. He is a  difficult intubation and 
requires cricothyroidotomy. He gets a right chest tube.He is hyper capneic, 
adequately oxygenated and acidotic with base deficiit of -7. 
 
Examination shows three penetrations: one to the lip with no exit wound, an 
entry in the LEFT anterior infraclavicular area and one to the thigh. There
is 
no major bleeding, or hematomas. 
 
Chest xray  shows opacities consistent with aspiration, ( likely of blood 
from the mouth), a widened mediastinum and a bullet in the RIGHT
supraclavicular 
region, with minimal hemothorax. Other portable xrays showed a bullet in the

thigh with no fracture and no other bullets in the torso.
 
How to proceed
 
sal sclafani
 



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