Original Publication
Open Access

Gunshot Wound Simulation Case

Published: January 25, 2012 | 10.15766/mep_2374-8265.9084

Included in this publication:

  • CXR_of_left_sided_tension_pneumothorax.jpg
  • FAST_exam_RUQ_with_free_fluid.jpg
  • FAST_image_of_bladder.jpg
  • FAST_of_LUQ_with_free_fluid.jpg
  • Revision_04_Adult_GSW_Trauma_Resuscitation.doc
  • Xray_of_left_sided_tension_pneumothorax_after_chest_tube_and_intubation.jpg
  • Xray_of_left_sided_tension_pneumothorax_with_chest_tube_placed.jpg

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Editor's Note: This publication predates our implementation of the Educational Summary Report in 2016 and thus displays a different format than newer publications.

Abstract

A male in his upper 20's sustains a single gunshot wound in the abdominal left upper quadrant/costal margin area of his lower chest. He is stable on the scene and transported via EMS to the emergency department. Upon arrival in the ED the patient becomes hypotensive and less responsive. The patient requires intubation and aggressive fluid resuscitation. He is found to have a left sided tension pneumothorax requiring needle decompression and placement of a chest tube. He is initially responsive to fluid resuscitation but requires emergent infusion of blood due to hypotension despite fluid resuscitation.

Prior to initial submission this simulation was run with multiple residents and a 4th year medical student and was found to be effective by both teaching facility and residents/student in covering major learning points in gunshot wound stabilization and treatment.

Since initial submission and before publication this simulation case was used to train interdisciplinary teams consisting of a total of 140 experienced EM physicians, nurses, nurses aids, respiratory therapists and technicians. The participants rated the learning experience as a 3.9 on a 4 point Likert scale.

Educational Objectives

  1. To demonstrate an appropriate primary assessment of an adult trauma victim.
  2. To complete an appropriately timed secondary survey.
  3. To recognize and treat airway compromise due to depressed level of consciousness.
  4. To recognize and treat hypotension due to tension pneumothorax.
  5. To recognize and treat hypotension due to hypovolemia secondary to intraperitoneal hemorrhage.
  6. To demonstrate correct sequence of steps to diagnose intra-abdominal and pelvic pathology using Focused Abdominal Sonography for Trauma (FAST) examination.
  7. To obtain appropriate laboratory and radiology studies.
  8. To initiate a timely surgical consult.

Author Information

  • Aaron Rubin, MD: Wright State University Boonshoft School of Medicine
  • Raymond Ten Eyck, MD: Wright State University

Disclosures
None to report.

Funding/Support
None to report.



Citation

Rubin A, Ten Eyck R. Gunshot wound simulation case. MedEdPORTAL. 2012;8:9084. https://doi.org/10.15766/mep_2374-8265.9084