35 Year Old Female with a Gunshot Wound Essay
Does the patient have intra or extraperitoneal bleeding that requires surgical intervention?
Does the patient have peritoneal contamination requiring washout and repair of a hollow viscus?
Penetrating injuries with any hemodynamic instability and/or signs of intraperitoneal injury are treated operatively at the outset of management
-GSWs most often injure the small bowel followed by the colon and liver
Does the patient have an adequate airway, and ability to protect it?
Is the patient breathing? Is oxygenation …show more content…
Physical Exam • A GSW to the abdomen is always explored. • Pay attn to the signs of abdominal penetration and try to reconstruct the path of injury • Be skeptical of apparent injuries: two holes aligned on a patient do not necessarily indicate entrance and exit wounds. • Does the patient have abdominal pain? Is the patient tachycardic and hypotensive because of peritoneal hemorrhage? Are respirations labored b/c of a distended abdomen and limitation to diaphragmatic excursions or because of a missed pneumothorax. • Check the NG tube after insertion: bloody nasogastric effluent? • Rectal examination may reveal blood w/in the bowel lumen. • Is the foley catheter draining blood tinged urine? • Whereas all of these findings may corroborate the need for laparotomy, hemodynamic