Male brought in tonight 'glassed' in the neck. Laceration about 6 cm long
at junction of middle and lower third of left sternomastoid. Obvious
muscle damage, has bled around 200ml or so; now not bleeding much.
Nothing else to find apart from associated grazes to neck and face and
haemodynamically stable.
I recommend putting him head-down to protect from air embolism. General
surgeon and ENT both disagree; if he has clot on the jugular vessels this
may be dislodged and cause further bleeding that may be difficult to stop
so they want him to be sat up overnight for observation to consider
angiography in the morning.
I acquiesced gracefully (yes, really!) as I was outvoted. However, I see
merit in both approaches. What do the team think?
/Rowley./
%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%
|