Trauma Scenario #2 with Dirty Pic ;)

[apssbc]

Ive been slacking around here so here is another scenario. You and your group of 5 other armed adults are ambushed by a group of undesirables, you respond and eliminate the threat. A member of your group is wounded in the abdomen by gunfire. This is the entrance wound, there is no exit wound. Recent total collapse TEOTWAWKI scenario, your skills and resources is all you have. Here is the patients info:

-25 year old Male
-GSW from approx 40 yards, victim saw the shooter
-Patient Screaming in extreme pain throughout the abdomen
-No Exit wound
-No major visible bleeding
-Skin pink warm and dry
-Rapid strong radial pulse and breathing



Some questions:
How would you treat the patient?
How could you secure the scene?
What can you do to determine the weapon and extent of injury?
Follow up question, Why is the weapon type, ammo and distance important?

GO!!

[ditchmedic]

Im not very good at these from the medical side, and im sure bilat 16's with LR and NS and transport to trauma center isnt feasible

Honestly, Im not keen on field surgery to look for a foreign object in someone's abdomen.

The pulse and breathing concern me as he may decompensate Pretty quick. The caliber concerns me cause of the size of the cavity and shock wave. Im more worried about the bullet not exiting. Not only does he have a bullet in him, but it tells me the bullet dumped its energy quick, Thats potential for a large temporary cavity.

Where in the abdomen He was hit and what the pain feels like would help me base my decision better, but he's probably done for.

[The Stig]

Does the GSW victim in this scenario have his guts hanging out as depicted in the picture?

Weapon, ammo type and distance would be handy to guess at the extent of the internal injuries. If it's a FMJ there's a chance it could have passed through. The absence of gushing blood perhaps means that while painful nothing major was hit. That said, he'd have to be monitored to ensure he wasn't bleeding out internally.

If it was a JHP or soft point the he could potentially be seriously hosed.

I think the key would be securing the scene pronto. 2 of the group would have to take up hasty overwatch positions to ensure the badguys friends don't respond to gunfire and screaming. You and your assistant would have to make an evaluation to see if the patient could be moved, even if only a few yards, to a position that would offer any cover if out in the open.

From there....well.....I guess calling a medvac isn't real likely eh?

[apssbc]

Awesome responses guys. Yes he is evicerated like in the picture.

As for the bleeding, remember with intestines hanging out they are plugging the hole. Also the abdomen can hold a lot of blood without it coming out. So it doesn't necessarily mean there is no major arteries hit.

[ditchmedic]

Awesome responses guys. Yes he is evicerated like in the picture.

As for the bleeding, remember with intestines hanging out they are plugging the hole. Also the abdomen can hold a lot of blood without it coming out. So it doesn't necessarily mean there is no major arteries hit.

Oh I thought the picture was just for funzies. He isnt having a good day, and tomorrow will be worse.

[Stormfeather]

Yup. . .what he ^^^ said.

[helomech]

If that is me, than end if for me quickly please. I don't see any real recovery from something like that without real medical care. And I sure as hell don't want to live for days suffering.

[bacpacker]

I agree with Helo. If SHJHTF that is just a slow painful death if they arent bleeding out internally.

[izzyscout21]

[apssbc]

Not all is lost on abdominal wounds. Don't get me wrong it would be a very very rough go of it. Not only the surgery but the recovery. Read through the NATO war surgery book. It's able to he found on the interwebs. Good material there.