0071643192.pdf
Flail Chest Flail chest is defined by the presence of fractures in more than one location on each of three or more adjacent ribs ...
Sternal Fracture Typically seen in victims of head-on MVCs, either from anterior chest striking steering wheel or from diagonal ...
COMPLICATIONS Mortality of isolated pulmonary contusion is up to 16% and greater with con- current extrathoracic injury. Pneumom ...
Aortic Injury/Traumatic Rupture of the Aorta (TRA) MECHANISMS ■ Consider in the setting of high-speed deceleration and lateral i ...
■ CT with contrast is a good test for stable patients. ■ Transesophageal echocardiogram can be performed at the bedside in unsta ...
■ Sucking chest wound ■ Subcutaneous emphysema ■ Auscultation should reveal diminished breath sounds. DIAGNOSIS ■ The presence o ...
TREATMENT In penetrating chest trauma, ED thoracotomy is indicated if: ■ Patient loses signs of life in the ED or immediately be ...
■ Diaphragmatic injuries misinterpreted as a hemothoraxmay be treated inappropriately with tube thoracostomy. CXR following NG t ...
■ High-grade liver injuries have a higher likelihood of requiring surgical intervention; however, these can be managed nonoperat ...
■ Major complications (bowel injury, bleeding, infection) have a 1% incidence. ■ A positive test is defined as drawing back 10 m ...
■ Peritonitis ■ Free air under diaphragm on CXR or on CT ■ Injury to pancreas, diaphragm, aorta, bowel, or kidney with urine lea ...
■ Shield the fetus whenever possible to prevent radiation exposure. ■ Because of concerns about radiation exposure, CT of the ab ...
Avulsion and single-bone fractures: Occur as a result of direct trauma from falls or from forceful muscle contrac- tion (see Fig ...
■ Oblique (Judet) views better define acetabulum fractures. ■ When one part of the pelvic ring has been fractured, always look f ...
GENITOURINARY TRAUMA Bladder MECHANISMS ■ Usually due to blunt trauma, often associated with pelvic fracture ■ Bladder contusion ...
Kidney MECHANISMS ■ Renal contusions (92%) ■ Renal lacerations (5%) ■ Minor: Cortical ■ Major: Involves medulla and/or collectin ...
Urethral MECHANISMS ■ Posterior urethral injuries typically result from pelvic fractures. ■ Anterior urethral injuries: Direct b ...
External Genitourinary Trauma PENILEFRACTURE Results from traumatic rupture of corpus cavernosum. Most commonly caused by blunt ...
EXAM ■ Dysphonia ■ Stridor ■ Tenderness ■ SQ emphysema ■ Loss of anatomic landmarks DIAGNOSIS ■ CXR, PA and lateral soft-tissue ...
■ Pulse deficit ■ Horner syndrome (ptosis, myosis, anhydrosis) ■ TIA/CVA ■ Motor or sensory deficits ■ Airway compromise DIAGNOS ...
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