- Joined
- Dec 4, 2003
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I don't work in a trauma center, and as a result, we see very, very little penetrating trauma. Unless it arrives by homeboy ambulance, such as this dude did. (Along with his buddy, who had also been stabbed in the back.) Both dudes managed to sustain hemo-pneumos, although the buddy's was minimal and managed with obs only. As far as their decision to sit at home for a couple of hours prior to presenting, well, that's a comment for the "what I learn from my patients thread...
Anyway, his VS are fairly stable (p 105, BP 120/70), he's cooperative and polite, admits to some Etoh earlier, occasional vices include THC and xanax bars. He's got a large hemopneumothorax, so I consent him for thoracostomy, and since he's fairly stable, I elect to sedate him for it.
40mg of Etomidate and 150-200 mcg of fentanyl later, he's still chatting away, cracking jokes and telling me he thinks it's pretty crazy that I'm feeling up his lung. I numbed him up well and did it mostly under local, but have never seen anyone who was merely relaxed under that much etom. Thankfully, he was pretty pleasant about it, but it was a first.
And no, the line wasn't infiltrated and he could feel the fentanyl when it hit.
Crazy.
Anyway, his VS are fairly stable (p 105, BP 120/70), he's cooperative and polite, admits to some Etoh earlier, occasional vices include THC and xanax bars. He's got a large hemopneumothorax, so I consent him for thoracostomy, and since he's fairly stable, I elect to sedate him for it.
40mg of Etomidate and 150-200 mcg of fentanyl later, he's still chatting away, cracking jokes and telling me he thinks it's pretty crazy that I'm feeling up his lung. I numbed him up well and did it mostly under local, but have never seen anyone who was merely relaxed under that much etom. Thankfully, he was pretty pleasant about it, but it was a first.
And no, the line wasn't infiltrated and he could feel the fentanyl when it hit.
Crazy.
