|
I redirected this so we could discuss "seemingly" small wounds.....think of this as a shrapnal wound. Take NO wound for granted. This guy didn't get to the OR for 4 hrs after his injury. The biggest problems he would face if his delay was 'in theater' in being evac'ed would have been with the small bowel injury, the slow but steady bleeding from the spleen and also the pancratic injury. All of these wounds are repairable but left untreated...the small bowel injury for greater than 8 hrs increases mortality significantly, eventually the spleen bleed would cause shock if it continued, and the pancreas would likely put him into big trouble 1-2 days later if not drained/repaired.
Small external wounds can have major internal injuries....let none of your teammates/commrades in arms not seek medical attention as soon as feasible....I imagine some one every once and awhile says they feel fine post injury...as did this patient the entire 3.5 hrs, it wasn't until after this that his belly started to bother him, his pulse and blood pressure and respiratory rate were all normal...
__________________
'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)
|