Scenario Sunday: A recent episode of Chicago Fire made me want to - TopicsExpress

Scenario Sunday: A recent episode of Chicago Fire made me want to give you this scenario. You are called to the scene of a construction accident in which, a 23 year old male worker has been accidentally shot with a pneumatic (air powered) nail gun, in the abdomen (RUQ) at close range. The nail is 3 long, the head of the nail is set flush to the skin surface. There is minimal external bleeding around the injection site. Your patient is panicking, complaining of severe pain and is becoming nauseated/dizzy. He is repeatedly trying to get a hold of the nail, begging you to help him get the nail out. He is obviously C/A/O, ambulatory on scene. Vitals: Respirations - 20bpm Pulse - 98bpm reg. BP - 120/58 Skin - W/D Abd. - no obvious distention noted What treatment would be appropriate? What organs may be involved? With the above vitals, do you suspect a life threatening internal bleed?

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