- Case History
- Nursing Records
- Results
- X-rays
- Questions
- Answers
1. How would you initially manage him?
He needs immediate intubation before his airway is completely occluded by the expanding haematoma. He will need blood cross-matching and surgery to control the bleeding.
Chest and neck X rays were performed.
2. Which anatomical structures would be at risk?
Larynx, trachea, carotids, jugular veins, brachial plexus
At operation he was found to have a transection of the right common carotid. The bullet track extended posterior to the vagus, which was intact, into the vertebral and pre-vertebral muscles. The bullet had caused a small chip to the vertebral body. The carotid was repaired with a patch and the bullet left in situ.
He was up and walking within a few days.
Learn more here
http://emedicine.medscape.com/article/869579-overview