HELP with a Case - X-Ray

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Ken
 
At this point if they have a CT scanner of reasonable quality and the
chest tube drains only a moderate amount (<1000ml stat), I would get a
CT chest and a contrast swallow. Is he moving his lower limbs?
 
Tim
Dr Timothy C Hardcastle
M.B., Ch.B. (Stell); M. Med (Chir) (Stell); FCS (SA)
Principal Surgeon-Lecturer / Sub-specialist: Trauma and Critical Care
Deputy director: Trauma Unit and Trauma ICU
Inkosi Albert Luthuli Central Hospital / UKZN
800 Bellair Road
Mayville, Durban
 
Postal: PostNet Suite 27
Private Bag X05
Malvern, 4055
KwaZulu Natal
 
timothyhar at ialch.co.za 
 
-----Original Message-----
From: trauma-list-bounces at trauma.org
[mailto:trauma-list-bounces at trauma.org] On Behalf Of KMATTOX at aol.com
Sent: 20 July 2008 03:49
To: trauma-list at trauma.org
Cc: SURGINET at listserv.utoronto.ca
Subject: Re: HELP with a Case - X-Ray
 
Great comments and questions.   Key are the questions regarding his
clinical status.   His pulses in BOTH arms was STRONG and BP in both
arms was equal at 150/90.     He hurt in his left chest, but had
bilateral breath sounds according to the peripheral hospital EC doctor.

 
Oh Yes, he did tell me some additional information and did send me the
chest X-ray electronically.      
 
The bullet entered in the posterior Left shoulder and was palpated in
the RIGHT anterior chest about 2 inches below the right nipple.     
 
When he called the ER Doctor was already putting in a left chest tube
because of the X-Ray Below.   Based on this NEW information, is there
any change to whether or not we should accept or reject the patient? 
 
 
 



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