ABSTRACT
A 20-year-old male is transported to the ED after sustaining a gunshot wound to head. His Glasgow coma score is 3 and a head computed tomography (CT) reveals a transcranial trajectory. Neurosurgery is consulted and the injury is deemed “nonsurvivable.” The patient is transferred to the ICU for further management. The patient’s blood pressure is 90/50 mmHg, his heart rate is 115 bpm. His pupils are fixed and dilated, but he continues to have a gag reflex.
