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C collar data for penetrating injury is based on "most likely trajectory" that may have caused direct cord/canal injury. Also based on physical assessment ie any focal neuro findings on exam.
98-99% of the time, non direct neck penetrating injury will not cause cord injury (unless posterior midline or 2 wounds to plot trajectory across the vertebral bodies)
No need for multiple chest seals: they are for "open" chest wall injuries and unless he took the blast at close range with disruption of the chest wall, no value to chest seals unless you hear or see air exchanging through a wound....and the chances of that occuring from a distand shot gun blast which this was (no wad injury noted on picture) are slim to none with bird shot size holes.
ss
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'Revel in action, translate perceptions into instant judgements, and these into actions that are irrevocable, monumentous and dreadful - all this with lightning speed, in conditions of great stress and in an environment of high tension:what is expected of "us" is the impossible, yet we deliver just that.
(adapted from: Sherwin B. Nuland, MD, surgeon and author: The Wisdom of the Body, 1997 )
Education is the anti-ignorance we all need to better treat our patients. ss, 2008.
The blade is so sharp that the incision is perfect. They don't realize they've been cut until they're out of the fight: A Surgeon Warrior. I use a knife to defend life and to save it. ss (aka traumadoc)
Last edited by swatsurgeon; 04-29-2013 at 12:56.
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