Doctors aren ’t cops: We need to change gunshot reporting

  On my first trauma shift as a fourth-year medical student, a young, disheveled man with blood-soaked pants hobbled into the emergency department. Wincing in pain, he offered me a bizarre history of being shot in the leg by a nail gun that went off after he dropped it on some stairs while helping a friend move. He lifted his right pant leg and removed the bloody, tattered bandana wrapped around his lower leg to reveal a pea-sized hole in his shin. After giving the patient some pain medications and briefly examining his wound with my attending, we sent him to radiology to determine the location of the nail and assess the damage it had caused in its trajectory through his leg. His X-ray, however, did not show a nail, but rather a bullet which had somewhat miraculously passed through the interosseous space between his tibia and fibula before coming to rest just under the skin overlying his calf. Back at the bedside, my attending gently pointed out the discrepancy. “You can tell the difference from an X-ray?” our patient asked, looking both surprised and alarmed. Before we had a chance to answer, the young man sprang up in his hospital bed and defiantly stated, “If I have to talk to a social worker about this, I’ll just leave right now!” Despite his naivety regarding the capabilities of modern X-ray technology, our patient was well aware that, by Washington State law, we were obligated to report his gunshot wound to local law enforcement, and that our social work ...
Source: Kevin, M.D. - Medical Weblog - Category: Journals (General) Authors: Tags: Education Emergency Source Type: blogs