2200 hours a pager in the operating room goes off advising of a level 1 trauma being brought in by med-flight gun shot wound to the chest internal bleeding seems steady. The patient will be carried from the helicopter pad to surgical trauma intensive care unit for pre operative testing. The surgery staff is notified and preparations to receive the trauma are put in place.
PREOP DIAGNOSIS: Gunshot wound left thoracoabdominal area possible injury to spleen, left lung, stomach, aorta and kidney. X-rays will be taken before surgery to see where the bullet is and any orthopedic trauma caused.
1. Exploratory laparotomy.
2. Splenectomy with distal pancreatectomy.
3. Left nephrectomy.
4. Evacuation of the bladder with primary repair.
FLUIDS: Include 8 units of packed red blood cells, 4 units of FFP, 1 pack of platelets, and 3-1/2 liters of saline SPECIMENS INCLUDE:
1. Bullet fragments sent to lab for law enforcement
2. Spleen sent permanent
3. Left kidney sent permanent
III Fresh traumatic wound from clean source
Gunshot wound to the left thoracoabdominal region. The patient was brought to the Operating Room for an emergency exploratory laparotomy. The Blood bank was notified to prepare for trauma needing type O blood until the patient could be cross matched. Before the procedure began the patient expressed an urgency to urinate but could not, a foley was placed and urine and blood came out.
DESCRIPTION OF SURGERY: The patient was brought to the Operating Room and placed in the supine position. A large laparotomy set was opened and prepared by the scrub, the suction units and liga sure were set up by the circulator a sternal saw and chest spreader were brought in and held if needed, the abdomen was then prepped and draped . A large mid line incision was made. There was a significant amount of blood immediately upon entry into the abdomen. The abdomen was then...