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Case Study: Possible GSW
Your team is dispatched to a possible assault in an alley behind Keith’s Coffee Bar at 2am. As you get closer to the scene, dispatch advises you that law enforcement is on scene is requesting entry. As you approach the patient you see a adult male party sitting up against a fence. The party is wearing a dark colored sweatshirt and dark jeans. The patient appears to be unresponsive. There are no visible signs of trauma noted. The patient does not respond to verbal stimuli, he responds to a trapezius pinch by moaning and withdrawing from the pain. The patient does not open their eyes in response to the painful stimulus. The patients airway appears to be clear. The patient’s breathing is rapid and shallow. You expose the patients chest and find:
Upon examining the posterior you find a similar wound just below the right scapula.
The patient does not have a radial pulse and his skin is pale and cool.
Head / face: there is no visible or palpable trauma noted.
Neck: the trachea is shifted to the left, there is no JVD noted.
Chest: breath sounds to the right chest are absent, left chest are clear.
Abdomen: no visible or palpable trauma noted.
Pelvis: a penetrating wound with a large amount of bleeding to the right pelvis:
Lower extremities: no visible or palpable trauma noted.
Upper extremities: no visible or palpable trauma noted.
Posterior: described above.
The patients V/S’s are: BP 78/60, HR 118, RR 24 and shallow, the pulse ox will not read.
You are unable to determine SAMPLE.
This is the scenario for your EMS 123 PCR #2.
Please post your “thread” answering the following questions along with posting your ED notification report. Once you have posted your thread, please reply back to at least two of your classmates threads. You MUST start your thread before you are able to reply to others. Thank you.
1) Does this patient have a pneumothorax or a tension pneumothorax?
a) Please explain the difference.
2) What is a junctional wound and how is it treated?
3) What ED are you transporting to?
4) Please list your interventions in the appropriate order.