20-30s y/o male (language barrier) shot once (through and th | Figure 1

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20-30s y/o male (language barrier) shot once (through and through) in the left leg/knee. Unknown caliber. Arterial hemorrhage on scene. Pressure dressing and first tourniquet did not adequately control hemorrhage. Second tourniquet applied. Vitals stabilized after fluid resuscitation. Pt ended up losing lower leg due to failed grafts. Popliteal injury. Vascular and ortho surgeons in house with a 7-minute transport time. Shout out to PD for recognizing arterial bleed and providing first tourniquet upon our arrival on scene.

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please answer the following questions: 1. What is the probable MOI? (Mechanism of injury). 2. When the patient FIRST arrives to the ER, what do you do? Should you assess the arm first, or do something else? 3. The first officer on the scene applied a tourniquet, how important is it to know the exact time the tourniquet was applied? 4. What types of imaging would you order? Why?

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