Patterico's Pontifications

6/14/2017

Hospital Issues Update on Scalise’s Condition

Filed under: General — Patterico @ 8:35 pm

It’s pretty grim but let’s remain hopeful.

Congressman Steve Scalise sustained a single rifle shot to the left hip. The bullet travelled across his pelvis, fracturing bones, injuring internal organs, and causing severe bleeding. He was transported in shock to MedStar Washington Hospital Center, a Level I Trauma Center. He underwent immediate surgery, and an additional procedure to stop bleeding. He has received multiple units of blood transfusion. His condition is critical, and he will require additional operations. We will provide periodic updates.

It was an attempted assassination, and Rep. Scalise faces a tough road ahead. Best to him and his family.

[Cross-posted at The Jury Talks Back.]

17 Responses to “Hospital Issues Update on Scalise’s Condition”

  1. That’s a wound that would have been fatal throughout almost all of human history. Let’s hope that it can be put right by the doctors.

    I’ll be watching the baseball game.

    Beldar (fa637a)

  2. As per a retweet from Ben Shapiro, condition has been changed to “grave”.

    Please no.

    harkin (485617)

  3. It was an SKS, after all.

    Federal agents are now tracing the origins of the two firearms recovered at the scene of the crime: an SKS 7.62.39 rifle (a Chinese-made variant of the popular AK rifle) and a 9-millimeter pistol, according to a law enforcement source. It is believed Hodgkinson shot at the politicians and staffers with the SKS rifle.

    http://www.cnn.com/2017/06/14/homepage2/james-hodgkinson-profile/index.html (Caution, autoplay)

    The SKS is the rifle of choice of left-wing bushwackers. It was also used by the sniper in Austin, and I believe in Baton Rouge. It’s not an AK variant, it is a predecessor, but it fires the same round, 7.62×39. A potent and damaging mid-range round. Not that any rifle round is not damaging or there is any good way to get shot.

    nk (dbc370)

  4. Did Leland Yee specialize in that product or are these holdovers from the Maoist movements of the 60-70s?

    urbanleftbehind (34dded)

  5. Oh yes,Leland ‘tong’ yee.

    narciso (8d53f7)

  6. The SKS? It was adopted by almost all the Communist countries and was manufactured alongside the AK for a long time for military use and may still be manufactured by the Chinese for export to the US. There’s tons of surplus ones available, in unissued new condition, although the prices have gone up a lot more than the $79.00 they were going for in the early ’90s. It makes a really good deer rifle and good all around rifle in its factory configuration minus the bayonet, comparable to the .30-30.

    I never had one. I had an AK for a while and did not like it, and soon lost interest in that whole category.

    Everything you always wanted to know about the SKS but were afraid to ask.

    nk (dbc370)

  7. The army surplus SKS was readily available in gun stores during the middle and late ’60s as the low cost alternative to much more expensive sporting rifles.

    In much the same way surplus WW-2 Italian infantry rifles had been sold in the early ’60s: $12.95 and bullets were 10 cents each. One was supposedly used to kill JFK.

    ropelight (f923af)

  8. Critical doesn’t mean significantly life-threatening, and life threatening doesn’t mean critical.

    I think there’s great confusion about what that means. Maybe the best meaning is: At least some important vital signs are abnormal and not stable, and the patient cannot be left alone.

    One website tries this:

    http://www.independent.co.uk/life-style/health-and-families/health-news/critical-and-serious-condition-what-hospitals-mean-when-they-report-a-patients-state-a6696701.html

    In the US, doctors use a series of definition that are part of the American Hospital Association Guidelines:

    Undetermined: Patient awaiting physician and assessment.

    Good: Vitals signs are stable and within normal limits. Patient is conscious and comfortable. Indicators are excellent.

    Fair: Vital signs stable and within normal limits. Patient is conscious, but may be uncomfortable. Indicators are favorable.

    Serious: Vital signs may be unstable and not within normal limits. Patient is acutely ill. Indicators are questionable.

    Critical: Vital signs are unstable and not within normal limits. Patient may be unconscious. Indicators are unfavorable.

    Those guidelines also tell hospitals to only communicate their patients’ condition, so it’s unlikely that anyone will ever say any more than that. But they are also only guidelines, which mean that spokespeople can say more or less — or choose their own terminology.

    This, from 2009 on Slate, is very similar:

    http://www.slate.com/articles/news_and_politics/explainer/2009/11/what_does_stable_condition_mean.html

    But it also says:

    Not all hospitals follow the AHA guidelines strictly. They’re advisory guidelines, after all, not regulations…the phrase “critical but stable” is in widespread use, though it’s not recommended by the AHA. The phrase is an attempt to communicate that some patients’ conditions are more “critical” than others.

    I think that critical, use dby itself, as it is used inb practice may not reflect too well what the AHA Guidelines say, doesn’t have too much to do with the prognosis. It probably has to do with vital signs, and the necessity of watching them.

    I see somewhere that “grave” is used to describe a situation where recovery is not expected. That is not what they were saying at first yesterday. It might be there’s a complication, like a clot pr internal bleeding or both. This needs more research.

    Sammy Finkelman (70818b)

  9. * I think that critical, usedby itself, as it is used in practice, may not reflect too well what the AHA Guidelines say, and doesn’t have too much to do with the prognosis. It probably has to do with vital signs, and the necessity of watching them.

    That said, one of the sillier things said yesterday (even though he really said it to buoy peopel’s spirits) was Speaker Paul Ryan saying something about how the worst thing, from Congressional Steve Scalise’s point of view, was having to miss the baseball game.

    Here it is:

    http://www.cnn.com/2017/06/14/politics/paul-ryan-steve-scalise/index.html

    “Now, knowing Steve Scalise as we all do, he is likely really frustrated that he will not be able to play in the baseball game.”

    Sammy Finkelman (70818b)

  10. A friend and I bought an SKS and an AK together in 1992. His SKS was $79.00 plus FFL fee and shipping. We also got 500 rounds of Chinese surplus ammunition for around $150.00.

    nk (dbc370)

  11. Sammy,

    I looked into it last night after I saw the use of the word “grave.” The hospital has never used that word.

    I think Tucker Carlson used the word “grave” to describe Scalise’s condition last night on his show. The Anchoress tweeted it and it was retweeted by others. I think it was an error that got magnified by repetition.

    DRJ (15874d)

  12. There is a new update from the hospital:

    Condition Update on Congressman Steve Scalise

    June 15, 2017, 8:10 pm

    Earlier today, Congressman Steve Scalise underwent a second surgery related to his internal injuries and a broken bone in his leg. He remains in critical condition, but has improved in the last 24 hours.  The Congressman will require additional operations, and will be in the hospital for some time. At the request of the family, we will continue to provide periodic updates.

    DRJ (15874d)

  13. Thanks for all the updating, DRJ.
    Much obliged.

    mg (31009b)

  14. @10. Wow. The weapon is so cheap; the wound is so severe; the care is so costly.

    Just awful. Let’s all hope and pray for a speedy recovery for him.

    DCSCA (797bc0)

  15. Listened to the latest presser yesterday. Miracle workers. But the key is he was alive when he got there. That’s due to the guys on the scene who knew what to do and did it. The Golden Hour.
    If you don’t take a round to the head or the heart, your next risk is bleeding out. There are crude and not complicated ways of dealing with major bleeds and it doesn’t take a long time to learn them. See Army Basic.
    Nearly fifty people died in the Orlando shooting, many likely because they bled out during the three hours’ negotiation. Despite horrid injuries including traumatic amputation, only three died in the Boston bombing because there were people on scene who knew what to do and did it immediately, and there was unhindered transport to first-rate hospitals.
    The Golden Hour. That’s not the pros’ responsibility.

    Richard Aubrey (a09608)

  16. It looks like it is true that if it had happened before Scalise would not have bene likely to survive.

    This would have bene true as recently as the early 1990s.

    Until then surgeons tried to do all the repairs in one operation. Then a medical study came out that said that in cases where the abdominal injuries were the most severe, patients had a 15% survival rate if doctors attempted to do it all in one operation, and a 77% survival rate if they did multiple operations. It takes something out of he body to do a long operation.

    This is not explained in a New York Times article, but I’m sure there is a readily deduceable explanation, although doctors might disagree on what it is and perhaps many will have it wrong. They now can do anything from 2 to 10 operations.

    There’s one thing to say. With surgery there is no need for FDA approval. This both means that mistakenly conceived operations get done, and that things can be adopted very quickly, and doesn’t cost extra money. In the long run we’re better off with the system used for surgery than for the system used for drugs and, now, medical devices. Everything would be better, of course, with better judgment.

    Sammy Finkelman (8cff4d)

  17. 15. The doctor in probably that press conference (I saw a soundbyte on TV) said that his condition was critical, however you define critical. He got 20 units of blood – and the body only has about 15. Ten units is already

    What goes on now is that in the first operation, they try to stop the major bleeding, coming from tips in large arteries and veins, often by packing the abdomen with sterile absorbent sponges, as well as look for damage to the small and large intestines, because bacteria can come out of there and cause sepsis.

    If the holes in the intestines are small, they might fix them right away; otherwise they may do some temporary fix or even remove a piece. They won’t connect them right away. Often the abdomen is left open, and the patient is wheeled into intensive care.

    The second operation is intended to repair small blood vessels. The patient is taken to the angiography room, where an angiogram is taken, to see leaks from blood vessels on X-rays. They are then plugged with small coils.

    In later operations, they may remove items with which a person can easily live without: The spleen or one kidney, (or the gall bladder?), or a portion of intestine.

    If plastic shints were used earlier to reroute blood around a major vessel with a leak, a permanent fix will now be made. If there is damage to the bladder or other major organs a person can’t normally live without, a repair will now be attempted.

    It can take some time, days or even a week, till the abdomen is closed. This has probably now bene done with Scalise.

    Sammy Finkelman (8cff4d)


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