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Question:
You are treating a 24-year-old female with a gunshot wound to the right side of the back. No exit wound is visible. She is awake but confused. Her skin is pale and diaphoretic with cyanosis noted to the oral mucosa. Breath sounds are clear and equal bilaterally. Jugular vein distention is present. Blood pressure is 90/78 mmHg, heart rate is 124 beats per minute, and respiratory rate is 28 per minute and labored. Sinus tachycardia is seen on the cardiac monitor. Which of the following treatment regimens would be the most appropriate for this patient?
A
High flow oxygen, spinal precautions, occlusive dressing over entrance wound, rapid transport.
explanation
Treatment of a gunshot wound to the thorax would include taking necessary spinal precautions. The open wound should be covered with an occlusive dressing. The respiratory distress should be treated with high flow oxygen with consideration of positive pressure ventilation and possible intubation. In addition, an IV should be started for a fluid route if hypotension worsens. Rapid transport is indicated for pericardiocentesis and possible surgery.
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