Megadoom's Gunshot wound/post crash management (Official multi-post series)

[freeyourmind]

Yes the black marks are is eyes, I've seen that picture unedited before. The most incredible part of it (IMHO) isn't that he lived, its that he appears to be CONSCIOUS in that picture. I mean, pain tolerance aside, a 357 hollow point should surely have knocked him unconscious for some time, no?

I mean, he's sitting up!

[EyesWideOpen]

Yes and no on the surprise for the first one surviving-how do you stabilize someone in that condition to get them into OR?

I hope you understand that I was not asking for more pictures btw-I have enormous respect for what you and your fellows do. I will say this though, pictures like these (this one and the shotgun blast from the previous post) would deter a lot of young people from attempting suicide.

When I was in high school back in the early '70s the school would show the car wreck films to us before prom and it was a deterrent.

[Megadoom]

Yes the black marks are is eyes, I've seen that picture unedited before. The most incredible part of it (IMHO) isn't that he lived, its that he appears to be CONSCIOUS in that picture. I mean, pain tolerance aside, a 357 hollow point should surely have knocked him unconscious for some time, no?

I mean, he's sitting up!

Yes, it's very amazing. Pain wise he's not in much, high sympathetic activation decreases sensitization - basically you're in a fight or flight mode. He was soon paralyzed and intubated and then whisked off to surgery.

[houseoftang]

Kind of funny that you'd black out the eyes.  I mean, can you recognize someone with half his face blown off?  Unless you happen to know someone with half his face blown off and can only recognize him by the eyes, I guess.  Not that many folks going around like that. . .

Did they manage to even vaguely reconstruct his face, out of curiosity?

This is why I've long said that if I were to suicide, I'd do something like blow myself up while falling, poisoned, from a skyscraper.

[Megadoom]

Yes and no on the surprise for the first one surviving-how do you stabilize someone in that condition to get them into OR?

I hope you understand that I was not asking for more pictures btw-I have enormous respect for what you and your fellows do. I will say this though, pictures like these (this one and the shotgun blast from the previous post) would deter a lot of young people from attempting suicide.

When I was in high school back in the early '70s the school would show the car wreck films to us before prom and it was a deterrent.

Stabilization for this guy would mean lots of suctioning to protect his airway which would be a paramedic's first priority, then we would set up two large bore (high volume) IV's 14g to both arms and monitor the BP closely. We would maintain the BP at 90 systolic or above by infusing if it should fall below that point. If the airway could not be maintained by suction and oxygen provided by NRFM (by blow in this case), we would RSI him - succ, paralysis medication, and intubate him to provide a secure airway (stick a endotracheal tube down his trache).

[Megadoom]

Kind of funny that you'd black out the eyes.  I mean, can you recognize someone with half his face blown off?  Unless you happen to know someone with half his face blown off and can only recognize him by the eyes, I guess.  Not that many folks going around like that. . .

Did they manage to even vaguely reconstruct his face, out of curiosity?

This is why I've long said that if I were to suicide, I'd do something like blow myself up while falling, poisoned, from a skyscraper.

Eye's are marked out from the source site because the pt. doesn't wish to be indentified; however unlikely, and the pt's face was successfuly reconstructed and it looked pretty good (big scars and facial depressions - but functional).

[EyesWideOpen]

The first thing I looked for was the trache tube. Again, what you and your fellows do on a daily basis is completely awesome in the old fashioned sense of the word.

[houseoftang]

Do you think pet supply places are a good place to pick up somewhat cheaper suture kits (or at least needles to practice with), and possibly other supplies?

Seems like most of the first-aid kits (not suture kits) are mainly band-aids and wipes.

[Megadoom]

Do you think pet supply places are a good place to pick up somewhat cheaper suture kits (or at least needles to practice with), and possibly other supplies?

Seems like most of the first-aid kits (not suture kits) are mainly band-aids and wipes.

Yes, some feed stores carry suture equipment, you could check there.

I sell the kits for $50 if interested.

[houseoftang]

The milsurp ones are :Surgical Instrument Kit: Packed in trifold canvas case with logo CONTENTS: 3 hemostats, 1 tweezer, 1 scissor, 1 probe, 2 scalpels, 2 sutures, 1 pull-back tool, 1 flashlight, 2 alcohol wipes, 2 antiseptic wipes

Is that basically the ones you sell, or are yours better?

Is it worthwhile to get a few needles of the various types?  103, 104, etc?

[Megadoom]

The milsurp ones are :Surgical Instrument Kit: Packed in trifold canvas case with logo CONTENTS: 3 hemostats, 1 tweezer, 1 scissor, 1 probe, 2 scalpels, 2 sutures, 1 pull-back tool, 1 flashlight, 2 alcohol wipes, 2 antiseptic wipes

Is that basically the ones you sell, or are yours better?

Is it worthwhile to get a few needles of the various types?  103, 104, etc?

Mine have everything but the flashlight.

Here's some good practice stuff for cheap: http://cgi.ebay.com/Suture-Tying-Practice-Kit-Manual-w-bonus-lot-50-packs_W0QQitemZ360196677172QQcmdZViewItemQQptZLH_DefaultDomain_0?hash=item53dd651e34

Yes, get multiple needle sizes and different types of suture material (3-0, 4-0 etc)

[houseoftang]

Hmm.  Do you think it'd be at all wise to have a few of the nice suture kits around, like the ones you sell and perhaps a few of the threaded needles, and a few of those (probably expired or something) ones around for when/if you run out of the good stuff?

[Megadoom]

Hmm.  Do you think it'd be at all wise to have a few of the nice suture kits around, like the ones you sell and perhaps a few of the threaded needles, and a few of those (probably expired or something) ones around for when/if you run out of the good stuff?

Don't let the expiration thing bother you....we're talking about a post apocalyptic world and the new motto will be - "geter done!" Get a good kit with the equipment: scissors, tweezer (surgical suturing type), and hemastats, etc and then stock up on various thread types and needles. They're cheap enough on ebay. Hell, I've found whole lots (100 or more needle/thread sutures) for less than $10. The real trick will be stocking up on antibiotics and things for pain, but in some cases pain relief might be a luxury. Pain is topic for another thread. We'll all have to learn to deal with alot more pain than we're used to.

[Broil]

I'll jump in for a moment if Megadoom doesn't mind, he can correct me or delete the post if he doesn't like it: Antibiotics, almost anything non-narcotic, and Tamiflu can be bought at alldaychemist.com , a site in India which according to several people is very reliable. 

I've been giving a lot of thought to pain relief.  Of the non-narcotic painkillers, doctors seem to think highly of ibuprofen for whatever reason.  I use that or tylenol and aspiriin together.  Aspirin can increase bleeding and so wouldn't be appropriate for surgical situations.  Tylenol has been getting a lot of press for causing liver damage if high doses are used.  All three are dirt cheap if bought in bulk.  Aspirin doesn't last for more than a few months if opened (smells quite vinegary if it's going bad), but it does have the additional benefit of heart protection.

Narcotic drugs are are the main painkillers and are very helpful for several problems, codeine or vicodin (hydrocodone) or oxycodone (percoset) are the ones I've had and they're all chemically similar.  They're actually safer than tylenol (paracetemol), which unfortunately is added to all of them to avoid over-use.  Codeine has three very good indications that I know of, those are for pain, for treatment of diarrhea, and for coughing.  Codeine cough syrup is very desirable to store away for the apocalypse, in my opinion, since it contains no tylenol.

It's hard to get narcotics of course because they make some of us feel so very good and get addicted.  You probably shouldn't store them in preps if you suspect you might have that problem, which is a major temptation for anyone like me who tends to get depressed.  One minute I'm feeling like something that should be flushed down a toilet, and the next I'm telling God, the laptop, and a stray cat how much I love them.  It's a real danger - you could use up your stash and have nothing to show for it but desperate withdrawal symptoms.

I won't stash them, but they're very worthwhile if you absolutely know you won't abuse them, and if you can keep your teenagers away from them (yes I know the little angels would never take any of your meds .... heh ...... just take my word for this).

[houseoftang]

Don't let the expiration thing bother you....we're talking about a post apocalyptic world and the new motto will be - "geter done!" Get a good kit with the equipment: scissors, tweezer (surgical suturing type), and hemastats, etc and then stock up on various thread types and needles. They're cheap enough on ebay. Hell, I've found whole lots (100 or more needle/thread sutures) for less than $10. The real trick will be stocking up on antibiotics and things for pain, but in some cases pain relief might be a luxury. Pain is topic for another thread. We'll all have to learn to deal with alot more pain than we're used to.

Probably good to get more than 1 kit, so you can sterilize one while you use the other, especially if you're in my situation, with a bunch of nurses and doctors in your lifeboat (who don't listen to you about doom enough to actually stock up themselves).

Are some hemostats and other equipment better than others?

I'll jump in for a moment if Megadoom doesn't mind, he can correct me or delete the post if he doesn't like it: Antibiotics, almost anything non-narcotic, and Tamiflu can be bought at alldaychemist.com , a site in India which according to several people is very reliable.

Many antibiotics and other medical supplies are also available at pet supply places.