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来源丨Figure1 Medical Cases，感谢授权！
阅读经典病例，讨论临床见闻 欢迎在评论区发表对病例的看法 发送MC0003至公众号后台获取中英文对照文档 
Cases dispatched for a possible GSW. Uponarrival found 19 year old male pt CAO x 4 who stated he heard 10 shots. Ptambulatory on scene and walked to stretcher. Pt had a possible entrance woundIn between his eyes.Bp 90/40s hr in the 50s. . Slow to respond at times. Rapid transport to level one trauma center. Bilateral16gtts NS. Pt arrived to trauma center awake and alert. Trauma team wasquestioning weather it was trauma from a fall or an actual GSW. Pt taken to CTand the first image showed this. Pt immediately began to seize and went intorespiratory arrest. Pt RSIed and sent to STICU. Discussion Still sedated has PMS x 4 and was following commandsyesterday. They removed the front of his skull bc they were worried aboutswelling and infections in his sinus cavity since it was shattered. The traumadoc told me there was actually two bullet holes in the front of his head. Ican't really comment on the CT but the doc told me it was bullet fragments, bloodand bone.
Wow! Surprised he was conscious at all! Must have continuedperfectly down the midline? I would assume lesser neurological function if ithad severely injured either hemisphere too greatly. Wow! Have they given him a prognosis? Also not familiarwith the acronym STICU? Presume an Intensive Care Unit but specialised? STICU stands for surgical-trauma intensive care unit Had a gun shot in the back of his head in a deal gonewrong. Entrance no exit. Arrived alert with no deficit. Complained of headacheand right neck pain. CT head and soft tissue neck showed soft tissue damageposterior scalp but no fracture or intracranial injury. Bullet passed aroundthe skull and into his right SCM missing major vessels. I admitted forobservation but he signed out AMA on floor.
What does "16gtts NS" stand for? Meant 16 GA IVs, normal saline The bullet is the large object that's pretty much perfectlycenter. The other hyperintensities above the orbit are what I would guess arefragments where the bullet entered the skull.
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