Trauma Flashcards
A-P compression fx pelvis with blood on rectal exam, whats best way to evaluate for rectal injury?
CT with rectal contrast
Tx of ectraperitoneal injuries requires proximal diversion unless greater than 50% of the lumen involved in which case do an end colostomy
Brown recluse bite (peds or adults)
rest, compression, elevation
close monitoring
potential need for coverage later
(dapsone)
what pediatric characterisitcs need to be taken into accoung when using Breslow
obesity
4 compartments in LE; fasciotomy with medial and lateral incisions. The medial incision can decompress which compartments?
Medial can decompress the superficial and deep compartments
32 F with tachy 135 and SBP<90, FAST indeterminate. What class of shock? and next best step?
Calss III
Whole blood!
CT cysto w extrav into the retroperitoneal space
extraperitoneal injury managed with foley for 10-14days w repeat cysto
penetrating gastric injury>3cm
primary repair
blunt cardiac injury with ST on EKG and FAST with no fluid. Next step in mgmt?
admit to tele
ECHO if pt is hypotensive or there is an arrhythmia
elevated R time on TEG?
FFP
increased K on TEG?
Cryo
increased alpha angle on TEG
cryo
max amp on TEG
platelets
LY30 elevated on TEG
TXA
Resuscitation in pediatric trauma patients with tachycardia or hypotension?
crystalloid bolus 20ml/kg crystalloid (up to 2x)
blood 10 mg/kg
injury to the distal third of the trachea… exposure?
Right POSTERolateral thoracotomy
uretral injury suspected and pt HDS, what to get?
CT w delayed cuts
ex lap with bleeding in RUQ, hepatic vascular exclusion to clamp both infow and outflow tracks and there is still brisk bleeding. Where from?
Replaced Right hepatic A
injury to trachea three rings below cricoid, how to repair
trachea reaired with absorbable suture with strap muscle buttress placed
blunt trauma w pseudoaneurysm distal to the left subclavian takeoff… what changes mgmt with endovascular repair?
endovasc repair with covered aortic stent that covers the subclavian artery
but if patient had bypass with left IMA risk ischemia
Blunt pos FAST in pelvis, CT cyst constrast outlining loops of bowel. Management?
Intraperitoneal bladder rupture and repair in 2 layers w absorbable sutures
MV A + wide mediastinum on CXR with small left pleural effusion, left first rib fracture. location of injury?
Aorta - tear of lig arteriosum with decel injury
Pringle maneuver
incise the avascular tissue between the caudate and the lesser omentum and sweep caudate to the right to expose the hepatoduodenal ligament thru the foramen of Winslow. Clamp placed
