gun shot..

I had just walked down from the ward and wandering around the ED entrance. I saw this car parked in front of the ED and one of the nurse was standing beside the car with the trolley. I walked toward the car and was a called by another nurse to be prepared in the resuscitation room - she told me there victim was a gun shot patient...
I gloved up and waited. The patient was still breathing when he entered. I felt the carotid pulse but the BP was unmeasurable. There were 2 wound - left chest and left upper quadrant fo abdomen - the heart and spleen area.... I asked the registration staff to inform the police and summoned the ambulance driver - I was gonna transferred him once I got all those tubes and lines in. We had no cardiothoracic surgeon and our general surgeon would be reporting 1 week later. All I could do is get a BP and sent him out stat. One of the 3 persons who sent him in had sticked his head in and asked me how his condition. I told him it was bad and asked him what had happend. He replied he dont know and quickly walk out from our hospital. The patient had standard look for a samseng/san qik la(3,7 chap ).  Well, I think he was one of the importants/high rank - tattoo all over his body and was neatly done...

those 2 hole was the gun shot wound 0.8cm ..... I confirmed spleen rupture with abd sono..

Since the patient was still breathing and complaining about shortness of breath. I decided to get the chest tube in first. There were 3 nurses assisting me but they look panic - no team work at all. I was grumbling but nothing to shout. The chest tube was inserted smoothly but still unable to get the BP . Only 1 line was inserted and the blood I ordered had not arrived. The EKG leads was not patched yet and the patient was showing me the white part of his eyes. I had to intubate him stat and start CPR. After the intubation, there was still 1 line only on the patient - he was a IVDU( with needle mark here and there...). So the CVP was inserted and by now I got my blood... it had been 18 mins since I lay my hand on him... Now the blood was up and Plasma expander flushing through the CVP like pipe water.. But still no BP...There was this same kinda of peoples poking their head out from the curtain from time to time. By 20 mins, I walked out and got his relative - mother, and told her that the patient was hit over the heart and I am losing him but I would try my best for another 10-20 mins.
I called it at 35 mins. There was a big crowd outside the ED. The polices, the family, guys from the same clan... I continue to see other patients waiting in the ED.
I was lucky - no reporter came...
the police requested to keep all the tube and lines - to facilitate the coroner with the autopsy...the patient was finally sent out 40 mins later.
My call that day was uneventful and I got a fair night sleep...
The next day, one of the local nurse told me that the victim was son to the head of local gangster, Mr. E. I knew this Mr. E, but I did not see him last night. Well, our works manager (a local who also PR person ) told me later that most of the local gangster came last night...it was a serious matter, should be some severe misunderstanding and dispute. There might be further incident in the future...
Well, I was lucky that night, I heard that some of the doctors were threated by the relatives during such resus situation : guns was pointed at the doctor head, requesting them to save the patient....