Trauma Surgery Flashcards
What type of pelvic fractures can you sustain?
AP Compression - front to rear
Lateral compression - impact from side
Vertical shear - from a height
combined - mixture of above
What is the management of pelvic fractures?
Advance Trauma Life Support approach (ABCDE)
When stable imaging to be gained to assess the damage.
- AP x-ray with inlet and outlet views
- CT
What is meant by unstable fractures? and why are these so serious?
Unstable is where there are two breaks in eh ring of the pelvis. This leaves it liable to opening - like a book.
these are subject to massive haemorrhage due to soft tissues contained within the pelvis.
namely the [sacral venous plexus]
- which if damaged can hemorrhage the entire blood volume
How are unstable pelvic fractures managed?
ABCDE
- 2 large bores - 2L of fluid
- cross match 4-6 Units
- apply Pelvic binder *or wrap bedsheets around pelvis to secure
Once secure and haemorrhage is controlled then surgical fixation is needed.
What is the most appropriate initial investigation to establish free fluid within the chest or abdomen following a trauma situation?
Focussed Assessment with Sonography for Trauma
- FAST scan
US
What sign suggests fracture to the posterior cranial fossa?
Battle sign
- bruising behind the ears.
Is someone has panda eyes, what is this suggestive off?
Base of skull fracture
If someone following an injury has diplopia upon unwards gaze, what is this suggestive off?
Blow out fracture of the floor of the orbit
If a patient has a score of <13 on GCS, when should a head CT be done?
Within 1 hour
What are the indications for a head CT within 1 hour?
GCS <13 2 hours post accident GCS <15 Vomiting Signs of skull fracture Focal neurological signs
What are the 3 x-ray views taking to look at neck trauma?
AP - open mouth
Lateral
Atlanto-axial
Trauma to the spleen:
Grade 1 - 3: managed conservatively
Grade 4-5: managed surgically.
Indication for splenectomy:
- bleeding that won’t stop
- hilus injury
- Devascularized spleen
