You folks get trained docs with a bevy of interventions at their disposal, so I would leave the knife in situ. What do I gain by yanking it in a stable patient? If need be, pull it if the patient decompensates in the air. Minh will probably show up with video which makes it even easier. Thoractomy will be something of a shitshow in this case. You would definitely want to do it as the BP is going way south but before arrest.
- The Belinda Tree.
- Quote of the day!
- ISAIAH: A Layman’s Commentary.
- Le journal dun fou (French Edition).
Clamshell is not doing you any favors, this is a posterior wound and your visibility is going to be poor with the patient supine. Probably better off going in with the patient propped up on some sheets, extend the L incision toward posterior and pray it is an intercostal that you can put pressure on with some sponges at both ends of the cut vessel, while your nurse pours in whatever blood and products this center has and hope the BP recovers. If it does, then some poor soul is going to sit there holding pressure until you can fly in a surgeon.
If it is not an intercostal, then it is lung. If you know how to find the inferior pulmonary ligament and cut it, then you can clamp the hilum or do a pulmonary twist. Both of these maneuvers are hard and the pt will prob die before definitive management can get there. Every ED doc should know how to perform a thoracotomy with the sole goal of opening pericardium and putting a finger on a hole.
This can be life saving anywhere regardless of the time for surgeons to arrive and is well within the skillset of the specialty. We would like to thank Scott for those comments, and for agreeing to be put on the spot. He made some great points, and his approach to this situation makes a lot of sense. And thanks to all our readers for their contributions and debate. This patient has several problems that are immediately apparent, and several more potential problems. In this situation one might feel a wee bit annoyed. As per any trauma scenario, follow the ATLS mantra. The Knife and the Wound It Deals.
Description Thirteen tales of gothic terror, chilling suspense, and uncanny occurrences, The Knife and the Wound It Deals leaves no strange stone unturned in the journey down the extreme and disturbing pathways of the human psyche. The subtly shocking opening story introduces the terrible monsters that can determine our fate, from external realities like death and time to internal demons like madness, lust, and revenge.
With a diverse range of settings, subjects, and themes, this collection connects the traditions of the gothic past to our equally disturbing present: a murder victim who refuses to stay buried; a World War II era wedding dress with a score to settle; the defeat and strange triumphs of death and bodily decay; a routine operation that reveals a horrifying secret world; an ancient burial ground that unearths a most bizarre set of corpses; the compulsions and consequences of desire, ambition, and dread The Knife and the Wound It Deals-a dark and disturbing exploration of the lurid obsessions, strange twists of fate, and mysterious forces that haunt our darkest midnight hours, plus a sneak preview of B.
Scully's controversial new novel All Things Truly Wicked. Product details Format Paperback pages Dimensions x x 18mm Rating details. Write a customer review.
Showing of 1 reviews. Top Reviews Most recent Top Reviews. There was a problem filtering reviews right now. Please try again later. I will read it again. Format: Kindle Edition. An advanced reviewers copy was given to the website Darkness Beckons for an honest review. Scully, I knew nothing of the author when I began to read and had purposely avoided all the information already available online.
Will Aughten is a man who doesn't live, he merely exists, terrified that he will unleash his closely guarded secret on the world. In the end he finds a far more terrifying truth. It is my opinion that someone who can pull off a great engaging short story is probably a better writer than someone who can write a decent novel. There is less room for filler, more need for the sharply observed solid character and tighter plotting required.
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Fascinatingly B. Scully changes voice in each and every story making it seem as if each one was authored by a different writer.
The Knife and The Wound It Deals
Each voice is as authentic as the last. So many of these stories could have been full length novels. This is a collection written with a deft hand, best read alone, where the floorboards creak the loudest. I want to read it again. This review was originally posted on www. See the review. Most helpful customer reviews on Amazon. Verified Purchase. Wonderful collection of tales by one of my new favorite authors B.
This lady just grabs at me with words and I am propelled along. Stories invoke images and make me think that they would be a good movie or shows on tv.
The Knife and the Wound It Deals eBook: B.E. Scully: uketerinucuz.tk: Kindle Store
I really believe B. I look forward to her next endeavor. Format: Kindle Edition Verified Purchase. This is a really outstanding collection of horror short stories. They're all in the classic style of writers like Poe, Lovecraft, and James.