debirlfan (debirlfan) wrote in little_details,

Sepsis from gunshot wound

Setting, 1980's Cambodian jungle.  Hero has been making his way "in country" up the Mekong and through the jungle for about a week, so can be assumed to be rather grungy and wearing not particularly clean clothing.

Hero is shot twice, once in the shoulder shattering his collarbone and doing some damage to nerves and a vein, and a second time a bit lower, puncturing the lung.  He receives almost immediate aid from someone with some medical training (former cop who served a remote area) who has access to a fully supplied doctor's bag packed for such an emergency and also has a doctor giving instructions via radio.

It takes at least 1-2 hours to get the hero to an actual doctor, and another couple hours to reach a hospital where he is operated on.

One of the wounds becomes septic to the point where he almost dies, but eventually recovers.

Note that there is one complicating factor.  Several years earlier, his spleen was removed (ruptured in an explosion).  My research tells me that this would make him more susceptible to malaria (yes, he's taking appropriate anti-malarials) but I've been unable to determine if it would affect the possibility of a systematic infection.

My questions -

How rapidly could the infection develop, and just how fast can he go from "he lost a lot of blood, but he should be fine" to "he's going downhill fast"?

Once they find the right antibiotics, how quickly would he respond to them?

I have googled and searched every web site I can find, and I've gotten lots of info on symptoms, treatment, various antibiotics, etc - but I can't seem to find anything about time - either becoming infected or recovering.  Also nothing on whether the lack of a spleen would have any impact.

Thanks for any possible assistance. 
Tags: ~medicine: injuries to order, ~medicine: injuries: gunshot wounds, ~medicine: septic shock

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