Limb shotgun

Question 1

20 yr M in a rural ED P/W LL shotgun wound with brisk hg from entry site , tachycardia ( 172 ) BP 58/27 , low GCS 8 , RR 24 , untraceable sats
outline your immediate mx ?

Answer 1

application of tourniquet 10 cm above the wound
2- MTP 1:1:1
3- early contact the state retrieval service for early transfer

Question 2

list 3 complications of prolonged tourniquet use

Answer 2

1- nerve injury 
2- pressure injuries 
3-reperfusion injuries 
4-limb ischemia 
5- compartment syndrome

Question 3

tourniquet conversion , explain this concept

Answer 3

removing tourniquet and replacing it with haemostatic /pressure dressing ( to prevent complications of prolonged tourniquet time )

Question 4

list 2 possible indications for tourniquet conversion

Answer 4

1- expected long tourniquet time >2hrs

2- bleeding controlled