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A 24-year-old previously healthy farm worker was out shooting rabbits in the field when he accidentally dropped his gun. The gun fired, shooting him in the left foot. He presented to the hospital hours later and was found to have entry and exit gunshot wounds to the foot. Multiple fractures of the talus, calcaneum and distal fibula were confirmed on x-ray and subsequent CT. He was admitted to the theatre for a washout.
On entering the recovery room, the patient initially coughed appropriately when extubation was attempted. However, he then lapsed into an unrousable state and was noted to be decorticate to painful stimuli. …
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