Statistics from Altmetric.com
KwaZulu-Natal, South Africa, operates a tiered emergency medical service and hospitals are graded according to the type of patient they can receive. The incidence of trauma is high and, owing to the mixed urban-rural population in KwaZulu-Natal, prolonged prehospital and interhospital transfer times are common.
An adult male with an abdominal gunshot wound had been taken to a rural clinic by relatives. The clinic had no resident surgeons and therefore a road transfer of at least 45 min to a trauma unit was required.
B: Respiration >28 breaths/min: no Spo2 trace was detectable.
C: Weak carotid pulse (100 beats/min), blood pressure (BP) unrecordable.
E Abdominal gunshot wound (level with the umbilicus) with no exit wound.
A 250 ml fluid challenge was administered but the absence of any response prompted a second fluid bolus and the application of the pneumatic anti-shock garment (PASG).
Following the fluid challenges …
Competing interests: None.
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.