When he arrived to the trauma ward he had LR running, I don't keep up with how much he got but less than 2 liters before we rolled to the OR.
No transfusion was done in trauma; the massive transfusion protocol was started because he was hypotensive on arrival but by the time the cooler (4u PRBC, 2u FFP) was ready we were on the way to the OR and honestly I don't remember if he got any of it beforehand; he responded well to just IVF resuscitation so we went ahead with the surgery any just ended up giving him 2 units afterwards (the crit we got in trauma was returned just after we left and was low, ~24 IIRC but it wasn't communicated to us... teamwork fail for sure but that can happen when we're rushing to the OR)
As for the rest of the meds? You'd have to ask anesthesia I guess. He didn't need anything from us in the ICU except a propofol/fentanyl drip to maintain sedation while intubated but that's pretty par for the course. The important part was that he was hemodynamically stable and not requiring pressors.
and:
I haven't spoken to the attending who was on staff that night but the other resident I was with that night doesn't remember it in any clarity (he was called to traumas as part of his rotation but that was ancillary to his ICU -different ICU btw- duties). Basically he said, "yeah that was weird, right?" At the time we were way more concerned with the rising class / new interns (July 1st is a terrifying time to be a patient lol) to make much notice... it always stuck in my head as something super bizarre but it was a long time before I even realized it was Seth Rich. When he arrived he was assigned by our system a trauma number, not a name as his patient ID. I only knew him at that time as Tra### (no freaking way that I remember the actual number). When it came to light who he was a while later I was floored. And terrified.
and:
Nope, nothing in the head so no freaking way we'd CT before going to the OR with a clear intraabdominal GSW. No need to FAST or anything, just stabilize and go to the OR
One could always just increase the propofol drip or give him a ton of roc and screw with the vent settings. No idea if that happened but it'd be easy if you have the right meds and access
and:
He had two holes in his right flank and one in the left upper quadrant. In trauma you always assume by protocol that 3 holes = 3 bullets but it was pretty clear that he was shot twice by the trajectory of the bullet (eg, his liver injury). I've also seen enough GSWs to know that the media doesn't get the number right every time.
Yeah, I'm not going to do that. Way too dangerous.
Alright anons it's been swell but I'll be gone for the next few hours for regular residency meeting / journal club BS. Take everything you read especially from the MSM with a grain of salt as usual but don't stop digging.
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jbooba ago
anon further stated:
When he arrived to the trauma ward he had LR running, I don't keep up with how much he got but less than 2 liters before we rolled to the OR.
No transfusion was done in trauma; the massive transfusion protocol was started because he was hypotensive on arrival but by the time the cooler (4u PRBC, 2u FFP) was ready we were on the way to the OR and honestly I don't remember if he got any of it beforehand; he responded well to just IVF resuscitation so we went ahead with the surgery any just ended up giving him 2 units afterwards (the crit we got in trauma was returned just after we left and was low, ~24 IIRC but it wasn't communicated to us... teamwork fail for sure but that can happen when we're rushing to the OR)
As for the rest of the meds? You'd have to ask anesthesia I guess. He didn't need anything from us in the ICU except a propofol/fentanyl drip to maintain sedation while intubated but that's pretty par for the course. The important part was that he was hemodynamically stable and not requiring pressors.
and:
I haven't spoken to the attending who was on staff that night but the other resident I was with that night doesn't remember it in any clarity (he was called to traumas as part of his rotation but that was ancillary to his ICU -different ICU btw- duties). Basically he said, "yeah that was weird, right?" At the time we were way more concerned with the rising class / new interns (July 1st is a terrifying time to be a patient lol) to make much notice... it always stuck in my head as something super bizarre but it was a long time before I even realized it was Seth Rich. When he arrived he was assigned by our system a trauma number, not a name as his patient ID. I only knew him at that time as Tra### (no freaking way that I remember the actual number). When it came to light who he was a while later I was floored. And terrified.
and:
Nope, nothing in the head so no freaking way we'd CT before going to the OR with a clear intraabdominal GSW. No need to FAST or anything, just stabilize and go to the OR
One could always just increase the propofol drip or give him a ton of roc and screw with the vent settings. No idea if that happened but it'd be easy if you have the right meds and access
and:
He had two holes in his right flank and one in the left upper quadrant. In trauma you always assume by protocol that 3 holes = 3 bullets but it was pretty clear that he was shot twice by the trajectory of the bullet (eg, his liver injury). I've also seen enough GSWs to know that the media doesn't get the number right every time.
Yeah, I'm not going to do that. Way too dangerous.
Alright anons it's been swell but I'll be gone for the next few hours for regular residency meeting / journal club BS. Take everything you read especially from the MSM with a grain of salt as usual but don't stop digging.
Sorry when i missed one, have to run!
privatepizza ago
Thanks thanks thanks for this, really, thanks.