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MET3a > Abdominal Trauma > Flashcards

Abdominal Trauma Flashcards

1
Q

Who?

A

Young men

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2
Q

Epidemic

A

Leading cause of death <50

18,000 deaths per year

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3
Q

When do deaths occur?

A
  • immediate within minutes of injury
  • within hours of arrival to hospital
  • late days - weeks after injury
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4
Q

Golden Hour

A

Period of time following traumatic injury during which there is highest likelihood that prompt medical and surgical treatment will prevent death

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5
Q

What info do you give at handover?

A 
ADMIST
Age
Time
Mechanism
Injuries
Signs and symptoms
Treatment
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6
Q

Haemorrhage

A
  • if SBP<90 -> access femoral artery for REBOA - resus endovascular balloon occlusion of aorta
  • CXR shows possible aortic injury?
  • if yes = no REBOA
  • if no = REBOA
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7
Q

Common abdominal trauma incidents

A

Deceleration injuries

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8
Q

Which organs are commonly injured?

A

Spleen - blunt trauma
Liver - stab wounds
Small bowel - gunshot wounds
Urethral tears

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9
Q

Blunt trauma

A
  • no break in skin
  • falls/sports/assaults/road traffic
  • spleen>liver>s & l bowel
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10
Q

Penetrating trauma

A
  • pierces skin
  • stab, gunshot
  • small bowel>stomach>pancreas
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11
Q

Crush trauma

A
  • compression
  • natural disaster/assault
  • rhabdomyolysis, crush syndrome
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12
Q

Ix for blunt trauma when haemodynamically stable

A

FAST = focused assessment with sonography for trauma

or CT if tenderness/bruising

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13
Q

Ix for blunt trauma when haemodynamically unstable

A
  • bleeding site identify and control
  • 2 large bore IV lines for resus + catheter
  • draw blood for crossmatch in case of transfusion
  • radiography = rule out haemothorax/pelvic fracture
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14
Q

Ix for penetrating trauma

A

Laparotomy if peritonitis/haemodynamic instability

- local wound explore to see perforation

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15
Q

Bowel Injury

A 
Penetrating>blunt
Peritonitis
Rigid abdomen and diffuse tenderness
CXR = pneumoperitoneum
CT = fluid, bowel wall thickening
Open abdominal surgery
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16
Q

Liver Injury

A 
RUQ Pain
Right Lower limb fractures
CT contrast = bleed, lacerations
FBC = low Hb and Hct
FAST
Surgical if haemo unstable
17
Q

Splenic Ijury

A 
Blunt>penetrating
LUQ Pain to left shoulder (Kehr's sign)
Left lower rib fractures
Hypovolaemia
CT contast
FBC
FAST
18
Q

Abdominal Compartment Syndrome

A

Intra-abdo pressure >200mmHg
Impaired organ perfusion
Due to too much fluid resus or massive blood transfusion

19
Q

Presentation of compartment syndrome

A

Increased airways pressure
Low UO
Tense Aodmen

20
Q

Management of compartment syndrome

A 
Optimise fluid balance 
Correct body position
Analgesia
Neuromuscular blockade
If fails = surgical abdo decompression

MET3a (38 decks)

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