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If gun shot associated with expanding hematoma or deterioration of vital signs or pt is coughing or spitting up of blood go for surgical exploration. In stable pt and absence of above go for angiogram :)
 

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Hmm, on USMLE World questions it said "All Gun Shot Wounds Require Surg. Exploration". So I would pick that always?
 

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Neck Exploration first and clinical observation for Spinal Cord injury
 

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If unstable patient .... surgical exploration in any part of neck injury ...
If stable patient ....
1. upper neck : angiographic embolization as surgery is tuf there and no vital structure .
2. Middle neck : immediate surgical exploration as vital structures are there ...
3. Lower part of neck : 2 Xray and 2 endoscopy
Xray : arteriogram and contrast esophagogram
endoscopy : esophagoscopy and bronchoscopy ......
 

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If unstable patient .... surgical exploration in any part of neck injury ...
If stable patient ....
1. upper neck : angiographic embolization as surgery is tuf there and no vital structure .
2. Middle neck : immediate surgical exploration as vital structures are there ...
3. Lower part of neck : 2 Xray and 2 endoscopy
Xray : arteriogram and contrast esophagogram
endoscopy : esophagoscopy and bronchoscopy ......
HMM where does this come from? Is it from Kaplan notes? If not then Why would you not do surgical exploration? Bullets do not Have a direct path many times and cause a lot of damage not seen by CT or angiograms at times.
 

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In Kaplan Notes

HMM where does this come from? Is it from Kaplan notes? If not then Why would you not do surgical exploration? Bullets do not Have a direct path many times and cause a lot of damage not seen by CT or angiograms at times.
This protocol is written in Kaplan Notes of surgery but as a paragraph so you have to collect them in an organized manner like this
 

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we need an expert here

reason I asked was because USMLE World said you must always explore bullet wounds.

I do not know which one is correct then? :scared:
Well I guess we need an opinion from an expert here
 
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