0071643192.pdf

Trauma In Pregnancy 172 Pelvic Fractures 173 Hip Dislocation 175 POSTERIORHIPDISLOCATION 175 Genitourinary Trauma 176 BLADDER 17 ...

A 40-year-old female is brought in by ambulance after sustaining a high- speed rollover MVC. She has signs of injury to the head ...

■ Following trauma, patients can elicit any of the five types of shock: ■ Hypovolemic (hemorrhage) ■ Distributive (brain/spinal ...

Secondary Survey ■ The secondary survey includes a directed history and a detailed physical examination. ■ A Focused Assessment ...

■ Motor exam: To assess for focal neurologic deficits or posturing ■ Decorticate posturing: Abnormal flexion of the upper extrem ...

■ Seizure prophylaxis with phenytoin to prevent early posttraumatic seizures; indications include severe head injury, intracrani ...

TRAUMA TABLE 3.4. Intracranial Hematomas TYPE OF PATIENT A NATOMIC LOCATION CT F INDINGS COMMON CAUSE C LASSIC SYMPTOMS Epidural ...

EPIDURALHEMATOMA ■ Usually associated with skull fracture after blunt trauma (see Figure 3.2) ■ Classically an injury to the mid ...

SYMPTOMS/EXAM ■ Vertigo ■ Hearing difficulties ■ CSF otorrhea or rhinorrhea ■ Mastoid ecchymosis (Battle’s sign) ■ Periorbital e ...

Concussion MECHANISMS ■ Any blunt trauma to the head: Sporting injuries (boxing, football, soccer, basketball, baseball) commonl ...

DIAGNOSIS ■ The decision to image the C-spine is based on the mechanism of injury, pain, tenderness, neurologic findings, and th ...

TRAUMA Abnormal soft-tissue findings on a lateral C-spine: Remember 6 at 2 and 22 at 6, and adjust up and down by 1 to get 7 mm ...

TRAUMA A B FIGURE 3.5. Jefferson Fracture. Odontoid view showing fragment from C1 to the right of the odontoid (A) and lateral v ...

TRAUMA FIGURE 3.7. Odon- toid fractures. (Reproduced, with permis- sion, from Tintinalli JE, Kelen GD, Stapczynski JS. Emergency ...

TRAUMA TABLE 3.6. Stable Fractures of the C-Spine TYPE MECHANISM NOTES Wedge fracture Flexion Multiple wedge fxs or loss of > ...

Brown-Séquard Syndrome ■ Hemisection of the cordusually associated with penetrating trauma ■ Symptoms/exam:Typically see ipsilat ...

■ Patients with C-spine fractures, ligamentous instability, or neurologic deficits consistent with a C-spine injury should be im ...

■ If a patient with an untreated pneumothorax requires intubation, consider chest tube placement prior to or immediately followi ...

DIAGNOSIS/TREATMENT ■ Diagnosis is clinical. ■ Immediate placement of a 14-g angiocatheter into the second intercostal space at ...

TREATMENT ■ Large-bore chest tube (36–40Fr): Smaller chest tubes will clot. ■ Massive hemothorax is defined as an initial output ...