Trauma Flashcards
Hard signs of peripheral vascular trauma
External bleeding Rapidly expanding haematoma Palpable thrill Audible bruit Acute limb ischaemia
Soft signs of peripheral vascalar trauma
Bleeding at scene Trauma close to major artery Diminished unilateral pulse Small non pulsatile haematoma Neurological deficit
Significance of hard and soft signs of peripheral vascular trauma
Hard: immediate surgery
Soft: examine, duplex scan, arteriography
Which fractures and dislocations have a high risk of peripheral vascular trauma
Supracondylar
High tibial
Knee dislocation
Posterior shoulder dislocation
Management of peripheral vascular trauma
Surgical exploration
Repair blood vessel
Fluid resuscitation
Blood transfusion
Where should you avoid putting a cannula in peripheral vascular trauma
Extremity leading to venous injury
Saphenous and cephalic veins (may need for bypass)
Most common mechanism of injury in chest vascular trauma
Rapid deceleration leading to damage to descending thoracic aorta at the isthmus
What other injuries are likely in chest vascular trauma
Tension pneumothorax
Cardiac tamponade
How to identify a brisk haemorrhage on CT
Arterial contrast (lighter) surrounded by other fluid (darker)
Treatment for thoracic aorta damage
Stent graft
Causes of traumatic retroperitoneal bleed
Angioplasty
Vas catheter e.g femoral artery
Pelvic surgery
Pelvic fracture
Signs of retroperitoneal haemorrhage
Lower back pain
Hypotension
Iliac fossa mass or tenderness
Under what circumstances should you highly suspect retroperitoneal bleed
Hypotension OR low Hb
Following femoral vascular catheter
Management for retroperitoneal bleed
Urgent CT
Fluid resuscitation and blood transfusion
Surgical repair
