Yesterday, at 2:00 am came to us 10 years old child post explosive injure, patient was unconscious.

A: patient was desaturated( O2 76%) and he was intubated due to his GCS was less than 8.

B: decrease air entry on left side so we have inserted a chest tube

C: blood pressure was unmeasurable but his radial pulse was palpable, we resuscitate him with fluid and blood.

D: Patient GCS was less than 8, pupils was anisocoria 

E: abdomen soft and lax, his pelvis and back was without any injuries.

We need to do FAST and brain CT, but unfortunately both of these test was unavailable, patient anisocoria means the patient brain will be herniate or it already have been herniated after that the patient will be die. 

We was lucky because the patient anisocoria has been improved on propofol. If these anisocoria not improved on propofol our plan was an old method ( brain exploration) using burr hole.

Another common problem in our hospital we have faced which is no any ICU beds were available, we solved it by discharge a patient from the ICU at 4:00 am and tell the patient members( the patient will be in the ICU) to be beside the patient who will discharge from ICU until his family comes.

#ceasefirenow #gaza #palestine #genocide