Question

For each of the following questions, you need to include the information from both the primary and secondary surveys BUT you need to include/address what is unique for each of these three separate situations.

Case Study 1

Situation for Assessment

Rodney G. is a 35-year-old auto repair mechanic who sustained a gunshot wound to the left chest during a robbery. Upon arrival of the rescue squad his BP was faintly palpable at 48 mmHg, his HR was 132 and his respiratory rate of 36. He is unresponsive and has a weak, thready carotid pulse. His skin is cold and clammy.

What could be happening?

What additional information would you like to further assess this patient?

What would you anticipate would be the appropriate interventions for this situation?

Answer 1

.1 A bullet can cause damage at the site of penetratuion and along its pathway.and a gun shot can cause a variety of pthophysiologic changes.The bullet may ricochet off bony structures and damage the chest organs and great vessels .if the diaphragm is involved in a gunshot wound injury to the chest cavity must be considered.

2Gun shot wound is the most common causes of penetrating chest traumaBased on the velocity gunshots may be classified as low,medium,or high velocity .The extent of damage can be interpreted by assessing the distance from which the gun was fired,the caliber of the gun,and the size of the bullet.

3 The objective of management is to restore and maintain cardiopulmonary function.After an adequate airway is ensured and ventillation is established ,examination for shock,and intathoracic and intraabdominal injuries is necessary.After the status of the peripheral pulses are analysed a large bore IV line is inserted .An indwelling catheter is inserted to monitor urine output.The patients blood is typed and crossmatched incase blood transfusion is required.Nasogastric tube is inserted and connected to low suction yo prevent aspirarion.Shock is treated simultaneously with colloidal solutions.A diagnostic workshop which include chest-xray,ABG analysis ,pulse oximetry and ECG is done.A chest tube is inserted into the pleural soace to achieve rapid and continuing reexpansion of the lungs.