๐๐๐ญ๐ข๐๐ง๐ญ ๐๐๐๐ค๐ ๐ซ๐จ๐ฎ๐ง๐
โ Age: 34 years
โ Health Status: Previously healthy
โ Incident: Attempted robbery with gunshot wounds
๐๐ง๐๐ข๐๐๐ง๐ญ ๐๐ฏ๐๐ซ๐ฏ๐ข๐๐ฐ
On the night of November 8, 2023, at approximately 10 PM, the Patient was brought to Inamdar Multispeciality Hospital, Fatimanagar, by his father and brother. The patient had sustained three gunshot wounds during an attempted robbery:
1. Left Calf – Entry and exit wounds
2. Right Thigh – Entry and exit wounds
3. Left Side of Face – Entry wound destroying the mandible with an exit wound
๐๐ฆ๐๐ซ๐ ๐๐ง๐๐ฒ ๐๐๐ฌ๐ฉ๐จ๐ง๐ฌ๐ ๐๐ง๐ ๐๐ง๐ข๐ญ๐ข๐๐ฅ ๐๐๐ง๐๐ ๐๐ฆ๐๐ง๐ญ
Upon arrival, the Patient was in critical condition, with clothes soaked in blood. The emergency team quickly performed an initial assessment, primary fluid resuscitation, and dressing of wounds to stabilize him. Immediate imaging included a face CT and a contrast CT of both lower limbs.
๐๐ฎ๐ซ๐ ๐ข๐๐๐ฅ ๐๐ง๐ญ๐๐ซ๐ฏ๐๐ง๐ญ๐ข๐จ๐ง๐ฌ
The patient underwent emergency surgery the following day, November 9, 2023:
1. First Surgery: Performed by Dr. Mustafa Shakir
โ Procedure – Exploration and debridement of wounds on the right thigh and left leg, hemostasis, muscle repair, and primary closure under general anesthesia.
2. Second Surgery: Performed by Dr. Mateen Sayyed
โ Procedure – Open reduction and internal fixation (ORIF) of the left para symphysis, right para symphysis, and left the body of the mandible. Dentoalveolar wiring, intermediate fixation, and closure of the oral floor. An elective tracheostomy was also performed to secure the airway.
๐๐จ๐ฌ๐ญ๐จ๐ฉ๐๐ซ๐๐ญ๐ข๐ฏ๐ ๐๐๐ซ๐ ๐๐ง๐ ๐๐๐๐จ๐ฏ๐๐ซ๐ฒ
Following the surgeries, the Patient was transferred to the Intensive Care Unit (ICU) for close monitoring and postoperative care. Key steps in his recovery included:
โ Hemodynamic Monitoring – Despite experiencing hypotension during surgery, which required intravenous norepinephrine (norad) for support, the patient name’s blood pressure stabilized postoperatively.
โ Metabolic Acidosis Correction – Patient arterial blood gas (ABG) analysis indicated metabolic acidosis, which was promptly corrected.
โ Blood Transfusion – Patient. received two bags of packed cell volume (PCV) on November 9, 2023, to manage blood loss. The transfusion was uneventful.
โ Sedation and Paralysis – The patient was kept sedated and paralyzed overnight to facilitate recovery. Norepinephrine was gradually tapered off.
โ Weaning Off Ventilation – Once the Patient regained consciousness, he was transitioned to pressure support (PS) ventilation and successfully weaned off. He began maintaining oxygen saturation on room air (RA).
๐๐ซ๐จ๐ ๐ซ๐๐ฌ๐ฌ ๐๐ง๐ ๐๐ข๐ฌ๐๐ก๐๐ซ๐ ๐
โ Oral Intake – The patient tolerated oral liquids well, and his nutritional intake was managed accordingly.
โ Hypokalemia Correction – Electrolyte imbalance was corrected, ensuring stable potassium levels.
โ Drain and Tracheostomy Decannulation – The tracheostomy was removed on November 12, 2023, and the patient name began ambulating well.
โ Suture Removal and Dressing Care – Sutures from the facial wounds were partially removed on November 16, 2023, under aseptic precautions (AAP), and the same was done for the left calf and right thigh wounds. Dressing changes were managed meticulously to prevent infection.
By the time of discharge, the Patient was hemodynamically stable, conscious, oriented, and ambulating well. He exhibited no signs of fever, and his wounds were healing adequately with no soakage. patient name’s liquid diet was well-tolerated, and his overall condition was significantly improved.
๐ ๐๐๐ฐ ๐๐๐ ๐ข๐ง๐ง๐ข๐ง๐
The patient was discharged with normal vital signs and no fresh complaints. His recovery journey was marked by resilience and the comprehensive care provided by the medical team at Inamdar Multispeciality Hospital.
This case underscores the importance of timely emergency response, effective surgical interventions, and diligent postoperative care in trauma management.
