Chapter 25 BAT Flashcards
Severe upper left quadrant pain following a motor vehicle crash, diagnoses are?
Blunt abdominal trauma (BAT) with spinal spleen injury and or lower rib cage fracture
What primary survey plus resuscitation should be done for all trauma patience?
Airway and cervical spine control, breathing, circulation, disability, exposure
What labs/radiology test should be ran for this patient after emergency orders and complete physical exam?
CBC BMP LFT UA ABG ECG amylase lipase, spine X-RAY, Chest XR, abdominal CT/US, +/-Pelvic x-ray urine output And Foley catheter (ICU)
These tests are ran in order to determine what?
Organ or skeletal injuries, metabolic acidosis from shock, severe blood loss
What test is used for BAT patients who are stable? Unstable?
CT abdominal, US abdominal
What should be ordered for anticipation of possible transfusion and or surgery?
Type and crossmatch, PT, PTT, NPO
What should be ordered if the patient has a history of drug abuse or AMS?
Toxicology screen
What should be ordered if this female is of childbearing age?
Beta-hcg
What’s the difference between the management of Stable subscapular splenic hematomas and splenic rupture with uncontrolled hemorrhage?
Splenorrhaphy or splenectomy
Where should this stable subscapular splenic hematoma patient to be admitted? What should be monitored?
ICU/ward, hematocrit
If there’s no intra-abdominal injury which should be done? If there is intra abdominal injury +/- hemoperitoneum what should be done?
Observe and perform serial exams; Hospitalized and consider conservative management or immediate laparotomy
What’s the criteria for doing an abdominal ultrasound instead of CT scan?
Unstable, unconscious, intoxicated;
What should be done if there is no intraperitoneal hemorrhage on the abdominal ultrasound?
Perform abdominal CT
What consult should be obtained in all patients?
Surgery
What are the emergency orders?
C-spine immobilization, IV access, IV NSS, pulse oximetry, oxygen, BP monitor, cardiac monitor
