Hey there,
this "mini scenario" is based off of something I was thinking about while studying today - I have never come across it personally. Thanks!
Patient is a 40 y/o male who was part of a bar fight. Initial impression is that there is one patient (the male listed) laying on the sidewalk outside a local bar at 0130. Police are on scene and have determined it is safe.
The patient is on the sidewalk in a "heap" but generally in the prone position with his hips slightly flexed. Initial assessment shows that he is responsive to painful stimuli with a GCS of 8 (E1, V2, M5). He currently has a patent airway and his respirations appear adequate but borderline shallow. Upon examination of the skin you find he has poor cap refill (environmental) - pale, cool, and slightly diaphoretic skin skins.
A rapid scan shows no sign of a skull fracture, contusions/abrasions to the right lateral aspect of the neck around C6 with no crepitus. There is a penetrating wound to the anterior right arm with no exit wound that is bleeding venously. There are multiple minor lacerations and abrasions on the abdomen. The most alarming find is a knife currently in the patient on the dorsal flank on his left side. It appears to be about 5-7 inches long and is penetrating completely in the left upper flank of the patient with only 1 inch not inserted.
Vital signs are taken and show BP 110/70, P 100 rapid and slightly thready, RR 24 with low tidal volume.
My question is how would you manage this trauma patient?
this "mini scenario" is based off of something I was thinking about while studying today - I have never come across it personally. Thanks!
Patient is a 40 y/o male who was part of a bar fight. Initial impression is that there is one patient (the male listed) laying on the sidewalk outside a local bar at 0130. Police are on scene and have determined it is safe.
The patient is on the sidewalk in a "heap" but generally in the prone position with his hips slightly flexed. Initial assessment shows that he is responsive to painful stimuli with a GCS of 8 (E1, V2, M5). He currently has a patent airway and his respirations appear adequate but borderline shallow. Upon examination of the skin you find he has poor cap refill (environmental) - pale, cool, and slightly diaphoretic skin skins.
A rapid scan shows no sign of a skull fracture, contusions/abrasions to the right lateral aspect of the neck around C6 with no crepitus. There is a penetrating wound to the anterior right arm with no exit wound that is bleeding venously. There are multiple minor lacerations and abrasions on the abdomen. The most alarming find is a knife currently in the patient on the dorsal flank on his left side. It appears to be about 5-7 inches long and is penetrating completely in the left upper flank of the patient with only 1 inch not inserted.
Vital signs are taken and show BP 110/70, P 100 rapid and slightly thready, RR 24 with low tidal volume.
My question is how would you manage this trauma patient?