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1. Advanced airway w/ c-spine. Wound to rt cheek and blast on that side would tell me massive baro trauma as well.
2. Ready to suction. Monitor breath sounds as best as poss.
3. Ligate, ligate, ligate. Hemostatic control agent. Package tight. Multi large bore IV. I like the IO. Bilat if poss.
4. Airevac to Neuro and vascular surgery. Pack limb to go with.
5. Be ready for a combative patient unless you have RSI or sedation meds.
Great case. How was the outcome, if I can ask. Thanks. adal
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