Medical Report: 23-Year-Old Iraqi Male, Baghdad, Iraq re: Gunshot Wounds to Chest

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MEDCOM - 17858
DOD-031432

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DOD-031436
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PT ,A/p) BHCG ' ETOH 2( GLU .96°. ct DIP MICRO 7L_ EKG INTERPRET TION -Stag.

PROVIDER HISTORY/PHYSICAL
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PATIENT'S IDENTIFICATION (For typed or written entries, give: Name -- last, first, middle; ID no. ISSN or other); hospital or medical facility)
'
cpct/ EMERGENCY CARE AND TREATMENT (Doctor) Medical Record
STANDARD FORM 558 (REV. 9-96)
Prescribed by GSA/1CMR FPMR 141 CFR) 10 1-11.203113)110) USAPA V1.00
MEDCOM - 17867
DOD-031441
510-112 NSN 7540-00-634-4123
MEDICAL RECORD NURSING NOTES
k.Digu cl ii notes) HOUR
DATE
OBSERVATIONS
A.M. P.M.
Include medication and treatment when indicated
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TIENT'S IDENTIFICATION

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hospital or medical facility)

REGISTER NO.
WARD NO.
I
NURSING NOTES Medical Record
(w6 -Y
STANDARD FORM 510 (REV. 7-91)
Prescribed by GSA/ICMR, FIRMR (41 CFR) 201-9.202-1

MEDCOM - 17868
DOD-031442
NURSING NOTES
(Sign all notes)
HOUR I OBSERVATIONS
DATE A.M. P.M. Include medication and treatment when indicated

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STANDARD FORM 510 (REV. 7—'U.S. Government Printing Office: 1995 -404-763/20065
MEDCOM - 17869
DOD-031443
NSN 7540-00-634-4123
NURSING NOTES
MEDICAL RECORD (Sign all notes)
HOUR OBSERVATIONS
DA I L Include medication ana treatment wneri iriniceieu

A.M. P.M.
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PATIENT'S IDENTIFICATION (For typed or written entries give: Name—last, first, middl
NURSING NOTES
Medical Record
eUW
STANDARD FORM 510 (REV. 7-91)
Prescribed by GSA/ICMR. FIRMR (41 CFR) 201-9.202-:

MEDCOM - 17870
DOD-031444

NURSING NOTES
(Sign all notes)
HOUR
A.M. P.M. OBSERVATIONS
Include medication and treatment when indicated
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MEDCOM - 17871 (AWN-
6) - z
DOD-031445

NSN 7540-00-634-4123
NURSING NOTES
MEDICAL RECORD Sign all notes) HOUR OBSERVATIONS
DATE
A.M. P.M. Include medication and treatment when indicated
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PATIENT'S IDENTIFICATION (For typed or wri entries give: Name—last, first, middle; grade; rank; rate; REGISTER NO. WARD NO. acility
ii.
NURSING NOTES
Medical Record
STANDARD FORM 510 (REV. 7-91)
Prescribed by GSA/ICMR. F1RMR (41 CFR) 201-9.202-1

(6)(6)-V
MEDCOM - 17872
DOD-031446
NSN 7540-00-634-4123510-112
NURSING NOTESMEDICAL RECORD
(Sign all notes)
HOUR
OBSERVATIONS
DATE
A.M. P.M. Include medication and treatment when indicated
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(Continue on reverse side)
PATIENT'S IDENTIFICATION (For typed or written entries give: Name—last, first, middle; grade; rank; rate; REGISTER NO. WARD NO. igthialligfacility)
NURSING NOTES Medical Record
MEDCOM - 17873 STANDARD FORM 510 (REV. 7-91)
Prescribed by GSA/ICMR:F1RMR (41 CFR) 201-9.202-1
DOD-031447
PREOPERATIVE/POSTOPERATIVE NURSING DOCUMENT
MEDICAL RECORD
For use of this form, see AR 40.66; the proponent agency is The Office of the Surgeon General.
al 2. KNOWN ALLERGIC SENSITIVITIES (e.g., Iodine, Tape, Medication):1. AGE:
HEIGHT:
3. PREVIOUS SURGERY [ NO [ ] YES (type):
WEIGHT:

4.
PROPOSED SURGIC L PROCEpURE:

5.
ADDITIONAL INFORMATION: Last PO: Medical lis:(22,) Implants: Medications:

.7

Jewelry removed:Ono Family waiting: yes not
-40- 106
6. PATIENT PROBLEMS AND NEEDS 7. PATIENT GOALS AND EXPECTED OUTCOMES 8. OR NURSING INTERVENTIONS
cr. Allow pt. to verbalize
A. PSYCHOSOCIAL o/rpt. verbalizes any specific anxiety. free) .
o xplain OR environment
Potenti3.1_for anxiety
„...--- and answer questions
Pt. exhibits relaxed body posture.
related to\-traumatie initiry;-• re g surgery.
language barrier; laTily _ Offer comfort measures,
(e.g., warm blanket, touch)

separatiot surgical environment")
o Explain all nursing procedures before they are done.

o-Remain with pt. whenever possible.

o Maintain family interface.

T. will be able to breathe without
I Offer to elevate head of difficulty during immediate intra-litter or offer pillow.
B. AERN o
/ Potential for
operative phase.
025bserve pt. while awaiting
res irato tion due to surgery for signs of distress
ed.atio • ositionio. ; injury
g.--Assist anesthesia during

intubation and extubation
er--IDT. will not exhibit signs of impair-
Utilize pressure preventing
C. INTEGUMENT
ment of skin integrity (e.g., reddened devices on OR table and areas. acyessories.
/Potential impairment
Check for proper
of skin integuity due to 41E.
positioning and support to
(6eqftsgiii(71 fluid shift main in good body alignment.

o Pad pressure points.

o lace ESU ground pad on

on compromised skin surface area

o Keep prep fluids from ooling.

9. PATIENT'S IDENTIFICATION (For typed or written entries give: Name- last, first, middle; grade; date; hospital or medical facility)
/\\611111111111,
( °
DA FORM 5179, JUN 91 Previoius editions are obsolete. USAPA V1.01
"Petilts
MEDCOM - 17874
DOD-031448

6. PATIENT PROBLEMS AND NEEDS
D. CIRCULATION
.../ Potential for inade-
quate.tiss e perfusion_due-to

‘tisithesia-a IC innir •
position; shock; previous surgery

E. NEUROMUSCULAR
CONTROL.%
./ Potential impairment

E.1.
,---..---)
of mobility due to Clatioalo.!-'
injury
Potential discomfort
E 2
due to frjury)a i n

,
F. NEUROMUSCULAR
CONTROL
Disminished visual

F.1.
perception due to being injury;
sedation;

Potential for decreased
F 2 communictaion due to language barrier; sedation
F.3. Potential injury due to
dentures.

G. OTHER PATIENT PROBLEMS NEEDS. Or continuation of a ove / problems/needs.
10.
7. PATIENT GOALS AND EXPECTED OUTCOMES
0----Pt. will exhibit signs of adequate
tissue perfusion (e.g., color, warmth,
pedal pulse).
tr-Pt. will be transferred to OR table without difficulty. 2-4;17-Civil! not experience unnecessary
physical discomfort.
•
o Pt. will be made aware of surroundings prior to anesthesia induction.

o Pt. will be transferred safely to

OR
table.

o Pt. will be able to understand instructions.

o Minimize danger of injury during intraop period.

OTHER PATIENT GOALS Alf ID EXPECTED OUTCOMES. Or continu on of above goals and outcomes.
8. OR NURSING INTERVENTIONS
0 Check for support stockings or ace wraps. If none, check with doctors. e—eneck that safety straps are correctly applied.
o Offer pillow for under knees.
0 Place and take down legs from stirrups with slow bilateral motion.
0--Check that rings have been removed.
Have sufficient people available for transfer. Insure proper body ali nt.
o Allow patient to lie in position of comfort while waitin f .r surgery.
Offer support (i.e., pillows, bathtowels, etc.) for positioning.
o Introduce self. Keep pt. informed as to where he/she is and what is happening.

o Inform pt. in which direction to move and assist if necessary.

o Speak clearly and slowly.

o Address pt. from side.

o Validate pt.'s

understanding of verbal communications.

o Verify removal of dentures.

OTHER NURSING
INTERVENTIONS.
Or continuati above
interveptidlis.

MPLETED/A DITIONAL INTEROPERATIVE INTERVENTIONS NOTED. C-...°1/ ZQ atAA g4­
..) MATE
11. POST ATIVE EVALUATION:
12 (6 )(0-7- ( ATION PREPARED BY 13. PREOPERTIVE EVA 11 U TION PREPARED BY LSi
DATE: TIME: 0 TE:Atzi gimED

REVERSE OF DA FORM 5179, JUN 91
MEDCOM - 17875 USAPA V1.01
DOD-031449
Y' r• t;
•

!;LUVL,.! . -V .'" 1 .. .. 1;41 ¦-: INTRAOPERA) )OCUMENT
:4, ''',,,,i,uw: ,.,.. • , 4. --, At ,:tici, ,..,4 , ' '''' For use of this form, see AR 40-66, the proponent agency is the office of The Surgeon General.
s-PA g . Fief TEATQ'OPERATING ROO 2. PATIENT ID D AND P EDURE
--,:t.fk
e-''... BY ,°

Ylkr VERIFIED BY (..
9.-DATE' - • . TIME PATIENT ARRIVED I ITE 4. PATIENTA 7M (6)(6)-2_...)-2 CLA-A-6.0_,3 TIME . 6 .5 7 NUMBER c-2- --
5. PREOPERATIVE EMOTIONAL STATUS
• CALM NXIOUS MI EXCITED • CRYING IN ANGRY II WITHDRAWN II OTHER (Specify)
COMMENTS: jt...„/Z )4)/ .z...4,i5 a-42.1 ; C..i Aa....4..•.1 6__ 6/
N -ir)
i
6. NURSING PERSONNEL
ASSIGNED '77(_-( RELIEF
SCRUB SCRUB

a) (6)- 2-
ASSIGNED €17 RELIEF
e..-/T-CPT all. to GE 64057-eJtA4 CIRCULATOR
/
cs)(0-2-
G Gt.-
rir
7. POSITION AND POSITIONAL AIDS (Specify).£&)U)-7
SUPINE MI LITHOTOMY . PRONE U KRASKE LATERAL: • LEFT SIDE UP IN RIGHT SIDE UP
COMMENTS:
B. SKIN PREPARATION
HAIR REMOVAL - YES . NO PREP SOLUTION (Specify)
DONE BY: OR NURSING UNIT SITE: c.A see_ tle B, / 5 111111

U W1
WHOM:
METHOD: DEPILATORY EtilAZOR SITE: BY WHOM: ( W‘ 0-2.-

. CLIP /
Tz( el (cJef te-1."..,,,::, (....-/.../

COMMENTS: COMMENTS:
9. LOCATION OF EXTERNAL DEVICES
=2PIL-
---'C(s.---tx 5
. .
11114111111111New
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_it
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gip (4)(6)--Z_ (ow/ 0), ,_/--"'"-----j°'f,
----L.
LEGEND d Pad -- Safety rap = = = Tourniquet
C = Correct I = Incorrect
First Closing Final Closing

10. COUNTS
Other" Count Count SCRUB CIRCULATOR
Sponge yes . No / , Cb)(b)--1 co( 0-2-
Needle Sharp Yes U No / E .
Instrument . Yes n No ------' -------

Other 1111 Yes E:27No _..--- v ...---'
----------,!'-----
11. PATIENT IDENTIFICATION (For typed or written entries give: 12. ELECTROSURGERY DEVICES) IESU) 0-7ES II NO
Name - Last, first, middle; Grade; Date; Hospital or Medical Facility;)

L-1-0 \ LID [2fSU NO: 1 6 c3OS V1--
GROUND PAD: BRAND l
\A--- R-51-Y`k i.PILf LOT NO: Vilsilip
NO: IN ESU NO:
GROUND PAD:
(.0(6) ' 9 BRAND LOT NO: II BIPOLAR NO:
R Arr-st,o,R A.oI 71,-1,
DA FORM 5179-1, OCT 87 REPLACES . --'HICH IS OBSOLETE. USAPA V1.01
DOD-031450
13.
PROSTHESIS, IMPLANTS . YES VNO IF YES NAME: ID NUMBER; MANUFACTI'RER

14.
-. -• ""' ''',awilmotgadm MEDICATIONS/ORDERSAN WOMOVet4

IRRIGATION/MEDICATIONS GIVEN IN OPERATING ROOM (NOT BY ANESTHESIA) (04)-7- YES NO • (6)(0-2.
EDICATIONS.SOLUTION DOSAGE TIME METHOD PREPARED BY

GIVEN BY
ete..,6•;-a.c..:,... 't r -1-7,4A-L4 csi. _5 C..-: #-?-1.-----ry t e....,--e By , Slart4(4 q cocto-7-coo -2--
WOUND IRRIGATION of YES • NO, TYPE(S):
0 .1 lo ki, cI.
TIME CARRIED OUT BY tOTHER ORDERS
PHYSICIAN'S SIGNATURE
15.
X-RAY IN OPERATING R OM IF YES, SITE
YES D NO

16.
LABORATORY SPECIMENS

SPECIMEN (SI NAME NAME
YES . NO , i7
FROZEN SECTION (FS) NAME NAME
YES • NO 1
CULTURE (C)
NAME NAME

r--
YES D NO
NAME NAME NAME
NAME NAME 18. DRESSING/IMMOBILIZATION (Specify)
N
17. TUBES. DRAINS/PACKING YES I:cV NO • ' "he (
TYPE/SIZE r. .1, 2. 3 . _0,44(..,012,to
,......ros.c
SITE 3.
1. (.\ii-4415L{
19. ADDITIONAL INFORMATION •
f..14...3-4j O-A .7,a /.4.,.) "4.4.4....-0-4.
0)(6)-2
(OW -7---
(t)(6).'7.-
20. OPERATION(S) PERFORMED
Ne a & ve /0 ra, to,o i
OQ --tz.-6-10--1-et-o -vt-P-egL.
• ,.1
21.
PATIENT TRANSFERRED TO TIME METHOD :....,::•;:,;::

22.
NATURE

._ ,,, ,
' ''. -.;-i.. ' • . :I.,.
..) (12)( 6) -. L ---4c'' ' . ' , -' . ' • — ' -a
C---.11)4" *...) --- -
.
REVERSE 5179-1, OCT 87
MEDCOM - 17877
DOD-031451

1.37"R ATPI tin lcm efC)OC
o
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MINIM /ob
orei rarany
IlEA7 111C71011Oa
wFmrai •
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Mammas
f"-¦
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)
MEDCOM - 17878
MEDICAL RECORD VITAL SIGNS RECORD
HOSPITAL DAY
g 5(103 bc(fio 4, 5,,,y
POST-DAY
') sSee
MONTH-YEAR DAY DT5T Pn CCI-63 10 S.-0
19 HOUR
0 7 A • ma • • 69,0-0 -
olfrb 1
063

is • •• 1 •
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PULSE TEMP. F : . . . : : . . . .
a co ac)
' • •
•
(0) (•) •• : : : : : : f : •• -5 • : :
• •. •.
105° .. .. .
.. .. .. .
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...
......
. . . . . .
. .

.

. . . . . . . . ................ . . . .
180 104° .........

. . . . . . . .
•
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...... .
o) co co N: ti ff cc; cp ori
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STANDARD FORM 511(REV. 7-95) •
1:2
MEDCOM - 17879
DOD-031453
NSN 7540-00-634-41:
.L)ICAL RECORD VITAL S R-,X)RD
HOSPITAL DAY ,OST-DAY
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Record special data only when so ordered
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VITAL SIGNS RECORDS
(6 )(6) 4
Medical Record
STANDARD FORM 511 (REV. 7-95)
Prescribed by GSA/ICMR • FiRMR (41 CFR) 201-9.202-1

MEDCOM - 17880
DOD-031454
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19 HOUR
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160 102°
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PATIENT'S IDENTIFICATION (For typed or written entries give' Name—last, first, middle; ID No.
REGISTER NO.
(SSN or other); hospital or medical facility) WARD NO.
STANDARD FORM 511 (REV. 7-95) BACK
(Centigrade Equivalents, for Reference only)
MEDCOM - 17881
DOD-031455