i thought as much...the timing was just off.

Cannot imagine having to make those types of decisions for teammates.... I try to distance myself from my patients although that is obviously not the case always. Withdrawals on awake, alert patients who have chosen to refuse care (ie. withdrawal of ventilation in quadraplegic patients) is always a very difficult thing for me and thankfully does not happen often.

As for my ABX choice, I do not have any formal training in treatment of infectious tissue. I only know of what I have read so my choice of Abx therapy is only as a SWAG, nothing more.

Is there a chance one of you more experienced in ABX therapy could go over the highlights of ABX therapy for field admin. Thanks.

what do the SF medics carry antibiotic-wise? I'll be happy to go over some of the stuff tomorrow.... will start a new post.

doc t.

Thanks for taking care of that for me Sacamuelas, appreciate it. I can't figure out if it's just the two weeks of continued lack of sleep or what.

Interesting case. I have to admit that I got the photo in the email from someone else, no idea what the case was. The "check your spot" was my sick sense of humor coming through. Although as some of the other have mentioned, it does happen.

My guess is that this was possibly a case of someone running into a vehicle with this pole protruding from the back of it. Much like the logger trucks you see all the time up and down the highway. I am trying to see if the angle would be right for a passenger vehicle. Considering that it definitely went through from front to rear (note jeans pushed through in front) I have to guess MVA or something even weirder than that. Possibly a MC, but that would be truly amazing.

I like the thought process on treatment. If agree that if it were me I say drug me to the hilt until my heart stops. I wouldn't want to survive that.

I would have to think the massive blood loss would lead to heart failure. I see the blood pooled in his left leg (livor mortis??)
I am not a doc, but one of the things I would consider was to get the leg off and remove the object. Then the time comes when we decide if the damage to the internal organs has been too bad. I wonder how much or how many were affected here??

I think we are spot on in saying that even if by some stretch of the imagination he survived, the massive infection/toxic shock syndrome would probably kill him.


I hate to say this, but I am thinking that they might just be keeping him alive long enough for the family to get there. I would never want to see my loved one like this. Ever.

Off the cuff
 

x

Re: Got Blood?
 

Nice!

Duh! :D

This guy could be some sort of lumberjack or tree trimmer. I had a friend who cut trees and one of his workers had tied a rope to one of the limbs to guide it down after he had cut it. The rope got away from the ground person and it swung back and struck the man up top square in the chest. Like putting your finger into a jelly donut. He of course died before EMS arrived.

Maybe this guy fell from his harness and struck a limb.

Anyway you look at it, this entire thread made my groin hurt. I don't know how all of you in the medical profession do it, but thank you.

Yes Ma'am, I'm sure there are. I was talking about in the field, with the guys in my unit. With an injury that serious I doubt any of them would be taking pictures, but you never know. My first room mate in the Army had pictures of his PL and PSG lying on the ground with GSWs to the 4th point of contact. They both made full recovery's, and he had the pictures hanging up on his wall locker.

I hate to say this but I damn sure would get photos if I could. Sad to say, everyone from the ER sitting around drinking some brews some night, the story would come up and no one would believe it. You'd then produce the photo.

"dude, I am telling you the thing was this big!!"

Okay, I know, my sense of humor is sick......:munchin

A6 Thats why I'm bringing a camera to the shoot. :D

Not to mention the fact for spawning continuing ed discussions on how to tx this pt such as this as well as cool material for powerpoint presentations...

and who doesn't love good powerpoint presentations...

Speaking of powerpoints......I remember (back in the day) when the State Troopers (GBTT) would bring in SLIDES (remember those kids??) of accident scenes and victims. Pretty gorry and graphic. But we learned a lot about what happens to a human being when involved in a MVA while not wearing a seatbelt.