A 5-year-old, 22-kg boy, previously healthy, is brought to the emergency room following a terrorist bombing at his school. He was in a remote corner of the gym when the bomb went off, also in the gym. He is writhing in pain in the ER, clutching his stomach, short of breath, and bleeding from his left ear. He has a broad bruise across his chest where he was hit by a volleyball pole. He seems to have difficulty hearing you in between his crying: HR 150 bpm, RR 28/min and crying, BP 75/50 mmHg, Hct 27%. There is a 22 ga. IV in place in the left saphenous vein, and seems to be running well.
KeywordsChest Tube Subcutaneous Emphysema Rapid Sequence Induction Moisture Exchanger Exit Wound
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