J Trauma
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Embolization of metallic missiles into the cerebral circulation is a rare occurrence. Most of the cases reported were due to gunshot wounds and shotgun wounds to the neck and face. Embolization from injuries sustained to the chest are extremely rare. We report a case of delayed pellet embolization to the middle cerebral artery resulting from a shotgun injury to the left chest.
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The goal of this study was to evaluate helicopter transport to an urban level I trauma center from the scene of injury for patients with self-inflicted gunshot wounds to the head. ⋯ The use of helicopter scene flights from the scene of injury for patients with a self-inflicted gunshot wound to the head provides no medical advantage to the victims, but provides a high-yield source of desperately needed organs. The prompt establishment of an airway in the field may prolong patient survival long enough to allow evaluation for organ donation. Helicopter transport of these patients is justified only as a means of rapidly delivering the personnel capable of providing advanced airway skills to the scene. Patients requiring CPR in the field after isolated gunshot wounds to the head will not live long enough to become organ donor candidates; therefore, there is no benefit to helicopter transport for these patients.