Saturday, February 2, 2008

Multiple GSW's

Last night we were called out to a GSW victim. We found the patient sitting in the backseat of a patrol car (not in custody, just sitting there waiting on us). The senior medic (a Captain) wanted the guy moved to the stretcher before starting an assessment, being on the transporting unit, I turned into the stretcher-fetcher.

Keep in mind our patient is approx. 6' and 300lbs. In the rig, we find 2 entrance wounds on his upper right thigh, 1 inside, 1 outside. Also 1 entrance wound on the outside of his left upper thigh. He's a big guy and we can't really get to the backs of his legs to do a better assessment (thanks Cap.)

Vitals 160/80, pusle 88, sats 99% room air, respirations 20.....We called in a report to our trauma center at this point.

I started an 18ga IV in his left AC, and attempted to give a bolus of Lactated Ringers. **I think the IV was positional and the patient kept calling everyone on his phone. **

I kicked everyone out of the truck so I could have room to move and also so we could get on the road. I finished cutting off the guy's pants and found a 2nd entrance wound near the first on the left thigh. He was also complaining of pain when he moved his right leg, and his "nuts are numb".

I called in an update, 4 entrance wounds, vitals 152/80, pulse 86, sats 99% on room air, respirations 20 nonlabored, IV established giving bolus, ETA 10

The patient's blood pressure continued to fall enroute and he became diaphoretic (sweaty).

Blood pressure was 114/52 on arrival to the ER, pulse 92, resp. rate and sats unchanged. Once the patient was moved to the ER's stretcher, we discovered a single exit wound on the back of his right thigh.

I left to type up my report and when I went back inside to drop off the copy, they were taking him to CT to rule out a pelvic fracture. You could clearly see 1 intact and fragments of a 2nd bullet in his left leg, they thought the round that didn't exit his right leg may have bounced upward and hit his hip.

I'm going to try to get an update on him next shift.

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