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Fri Aug 31 13:26:35 BST 2007

Place chest tube, assess output and re-assess vitals and repeat CXR to see
if large hemo-pnuemothorax is drained and lung is expanded. 

Find bullet. (Is that thing in the med chest a marker of some sort? Weird
looking for a bullet) Work up organs and things at risk in path of bullet.

Rob Smith

-----Original Message-----
From: trauma-list-bounces at trauma.org [mailto:trauma-list-bounces at trauma.org]
On Behalf Of SJASMD at aol.com
Sent: Thursday, August 30, 2007 10:47 PM
To: trauma-list at trauma.org
Cc: sclafans at nychhc.org
Subject: GSW TO RIGHT CHEST. WHAT IS THE WORKUP OF THIS CASE

We seem to be having a run of interesting gunshot wounds of the chest at
our hospital. I have been in disagreement with the management of many of
them and look to this site to give me a reality check. Here is another chest
case.

This case is a 35 year old male who sustained a single gunshot wound of the
right chest posterolaterally with no exit wound. He presented alert, but
short of breath . On exam he was normotensive and diminished breath  sounds
in the right chest.. There was an entry wound in the postero lateral area
of his right thorax around the seventh intercostal space. but no exit
wound.

He was sent for a chest xray which i share with you.

next step?

sal 

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GSW TO RIGHT CHEST. WHAT IS THE WORKUP OF THIS CASE