03-09-2004, 21:20
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#31
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Guest
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the guy with the retained fence post did well however...but not my patient.
doc t.
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03-09-2004, 21:24
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#32
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Quiet Professional
Join Date: Jan 2004
Location: LA
Posts: 1,653
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No, I wasn't looking for a pat answer. I'll leave you alone because its been a long week.
NO SNIVELIN' ITS ONLY TUESDAY!
LOL
__________________
Somewhere a True Believer is training to kill you. He is training with minimal food or water, in austere conditions, training day and night. The only thing clean on him is his weapon and he made his web gear. He doesn't worry about what workout to do - his ruck weighs what it weighs, his runs end when the enemy stops chasing him. This True Believer is not concerned about 'how hard it is;' he knows either he wins or dies. He doesn't go home at 17:00, he is home.
He knows only The Cause.
Still want to quit?
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NousDefionsDoc is offline
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03-09-2004, 21:33
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#33
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Guest
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my week started on sunday...that is the way my calender goes...so I have already put in a full weeks work by most people's standards... lol....
as for the guy....blood is hanging so I have to assume he was unstable...
vascular injury remains an independent risk factor for death in a trauma patient with a penetrating injury.... combined with the probable need for a damage control procedure, he has a very poor prognosis. I base my thoughts that he will need damage control on the fact that blood is hanging and I imagine multiple internal injuries... rectum, colon, bladder, pelvis...etc...
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03-09-2004, 21:35
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#34
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Quiet Professional
Join Date: Jan 2004
Location: LA
Posts: 1,653
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Quote:
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so I have already put in a full weeks work by most people's standards... lol....
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nice one.
Note to self - Doc T is sharp even when tired. Leave her alone. LOL
Thanks for the additional comments.
Ok - whoever said "bullet" was right.
NEXT! 
__________________
Somewhere a True Believer is training to kill you. He is training with minimal food or water, in austere conditions, training day and night. The only thing clean on him is his weapon and he made his web gear. He doesn't worry about what workout to do - his ruck weighs what it weighs, his runs end when the enemy stops chasing him. This True Believer is not concerned about 'how hard it is;' he knows either he wins or dies. He doesn't go home at 17:00, he is home.
He knows only The Cause.
Still want to quit?
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NousDefionsDoc is offline
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03-09-2004, 21:37
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#35
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Guest
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bullet?
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03-09-2004, 21:39
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#36
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JAWBREAKER
Join Date: Jan 2004
Location: Gulf coast
Posts: 1,906
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Eagle and I must be on to many medications. Am I crazy or Did anyone else read the change in scenario involving the right thigh only that Eagle suggested we worK?
I am interested to hear GUy and Doc T's ideas about that specific situation as it is a liitle more realistic in prognosis.
Doc T- if you are to tired... by all means ignore my suggestion. BTW, I finally cleared my PM folder. Sorry
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"If you live here you better speak the language. This is supposed to be a melting pot not a frigging stew" - Jack Moroney
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Sacamuelas is offline
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03-09-2004, 21:40
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#37
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Quiet Professional
Join Date: Jan 2004
Location: LA
Posts: 1,653
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Quote:
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If that were me, I would like my medic to prescribe and accurately deliver a .45 round to the brain.
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RoguishLawyer. Sorry dude, old habits and all.
__________________
Somewhere a True Believer is training to kill you. He is training with minimal food or water, in austere conditions, training day and night. The only thing clean on him is his weapon and he made his web gear. He doesn't worry about what workout to do - his ruck weighs what it weighs, his runs end when the enemy stops chasing him. This True Believer is not concerned about 'how hard it is;' he knows either he wins or dies. He doesn't go home at 17:00, he is home.
He knows only The Cause.
Still want to quit?
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NousDefionsDoc is offline
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03-09-2004, 21:45
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#38
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Suffering from SF TDY Envy
Join Date: Feb 2004
Location: null
Posts: 228
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I am with RL on this one. I also would hope no one was standing around taking pictures, if I lived the .45 round would be for him!
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ktek01 is offline
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03-09-2004, 21:49
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#39
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Guest
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nowadays there is a digital camera in most ERs....
as for Eagles scenerio...had missed it.
vascular compromise....no pulse, decreased pulse?
is there bleeding from the wound causing shock or is it just bleeding at the fracture site of the femur as he described a pole going through the upper right thigh...
doc t.
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03-09-2004, 21:55
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#40
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JAWBREAKER
Join Date: Jan 2004
Location: Gulf coast
Posts: 1,906
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Who..Me??
Hey your the mullah in this mosque....how do I know? LOL
I didn't even think to ask those questions. haha
Let's say diminished pulse present... majority of bleeding around the fractured femur internally.
Would you remove the object and do your best if you knew he had to wait a minimum of 14 days before a possible evac out of the grass hut clinic? Or would you sacrifice the leg to maybe save the patient by leaving the object in?
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"If you live here you better speak the language. This is supposed to be a melting pot not a frigging stew" - Jack Moroney
Last edited by Sacamuelas; 03-09-2004 at 21:58.
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Sacamuelas is offline
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03-09-2004, 21:59
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#41
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Quiet Professional
Join Date: Jan 2004
Location: OCONUS...again
Posts: 4,702
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I'll actually probably dream about this tonight. The prognosis does not look good.
As an operator...
If he were conscious...I would medicate him to the point of no return.
If he were unconscious...I would most likely end it w/o wasting meds.
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“It is better to have sheep led by a lion than lions led by a sheep.”
-DE OPPRESSO LIBER-
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Guy is offline
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03-09-2004, 22:08
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#42
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Guest
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Quote:
Originally posted by Guy
I'll actually probably dream about this tonight. The prognosis does not look good.
As an operator...
If he were conscious...I would medicate him to the point of no return.
If he were unconscious...I would most likely end it w/o wasting meds.
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is this your answer for the guy in the photo or the guy with the post through his leg with a decreased pulse?
for the decreased pulse with bleeding in the fracture I'd hope you'd go all out... May just be an intimal flap or spasm.... Would in that case try to remove the foreign body and hope for the best but be prepared to tourniquet or clamp because no one can hold pressure for two weeks!
Broad spectrum antibiotics....you guys are all utd on tetanus... never close skin on a dirty wound...irrigate and debride what looks dirty...you'll be pulling wood splinters out for a while .... dressing changes a few times a day into the cavity.
doc t.
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03-09-2004, 22:11
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#43
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JAWBREAKER
Join Date: Jan 2004
Location: Gulf coast
Posts: 1,906
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Thank you Doc T.
I was wondering about my decision to suture verses pack the wound. I had a feeling I was wrong on that. 
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"If you live here you better speak the language. This is supposed to be a melting pot not a frigging stew" - Jack Moroney
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Sacamuelas is offline
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03-09-2004, 22:22
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#44
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Quiet Professional
Join Date: Jan 2004
Location: OCONUS...again
Posts: 4,702
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I was talking about the picture.
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“It is better to have sheep led by a lion than lions led by a sheep.”
-DE OPPRESSO LIBER-
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Guy is offline
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03-09-2004, 22:29
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#45
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Quiet Professional
Join Date: Jan 2004
Location: Wherever my ruck finds itself
Posts: 2,972
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Sorry I am late to return...busy night
Quote:
Originally posted by NousDefionsDoc
Why Ketamine Crip?
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Just a guess NDD. Am I wrong?
I dont have much experience with anesthesia other than NO2, and the common RSI drugs.
__________________
"It's better to die on your feet than live on your knees."
"Its not who I am underneath, but what I do that defines me" -Batman
"There are no obstacles, only opportunities for excellence."- NousDefionsDoc
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