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Usual initial priorities. Questions to answer include: ebl enroute, how much active bleeding in trauma bay, can the bleeding be controled by direct pressure, is there normal anal sphincter tone, is blood being passed out the urethera, any rectal bleeding, is the patient hemodynamically stable?
Two large bore IV's, pelvis films, soft tissue studies if possible. This needs to be explored in the OR. Is this the time to try to pass an indwelling uretheral cath? Said cath can help with hemostasis if needed IMHO. Do have some concerns with bone frags if the projectile impacted any bone. Prostate, bladder and bowel issues need to be considered as well as pelvic vascular structures.. If there is much prostate damage, there could well be significant bleeding in the pelvis that could go undetected.....could see quite a bit of blood loss in surgery as well.
As for long term outcome, we do know from a celebrated case a decade or so ago, that the appendage can be re-attached after complete amputation. From the photos, the appendage does not look cyanotic and likely viable. Physiological function and reproductive abilities likely best determined in surgery and with post-op outcome, more than a bit out of my specialty here.
As for mechanism of injury....I doubt it will happen again with this solider.
Interesting professional subject.
My $.02.
RF 1
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