Hello!
When you are presented with a case of blunt abdominal trauma (BAT) in your exam, first determine whether the patient is stable or unstable.
If unstable - resuscitate!
In hemodynamically unstable patients with BAT, management depends on: presence or absence of intraperitoneal hemorrhage.
Therefore, focused abdominal ultrasound (US) exam (or in some instances a diagnostic peritoneal tap [DPT]), to make this determination.
If hemoperitoneum: Laparotomy.
No hemoperitoneum: Search for extra-abdominal sites of hemorrhage.
If stable - assess risk for abdominal injury.
Low-risk: Assessed by clinical presentation, vital signs, and laboratory tests (no anemia, elevated transaminase concentrations [if obtained], or hematuria)
Management: Nine-hour period of observation - serial vital signs and abdominal examinations.
High-risk: Assessed by clinical presentation, laboratory findings associated with intra-abdominal injury (hematocrit < 30 percent, AST or ALT > 130 units/L, microscopic hematuria > 25 red blood cells [RBCs] per high power field)
Management: CT scan is the preferred modality for identifying such injuries.
That's all!
-IkaN
When you are presented with a case of blunt abdominal trauma (BAT) in your exam, first determine whether the patient is stable or unstable.
If unstable - resuscitate!
In hemodynamically unstable patients with BAT, management depends on: presence or absence of intraperitoneal hemorrhage.
Therefore, focused abdominal ultrasound (US) exam (or in some instances a diagnostic peritoneal tap [DPT]), to make this determination.
If hemoperitoneum: Laparotomy.
No hemoperitoneum: Search for extra-abdominal sites of hemorrhage.
If stable - assess risk for abdominal injury.
Low-risk: Assessed by clinical presentation, vital signs, and laboratory tests (no anemia, elevated transaminase concentrations [if obtained], or hematuria)
Management: Nine-hour period of observation - serial vital signs and abdominal examinations.
High-risk: Assessed by clinical presentation, laboratory findings associated with intra-abdominal injury (hematocrit < 30 percent, AST or ALT > 130 units/L, microscopic hematuria > 25 red blood cells [RBCs] per high power field)
Management: CT scan is the preferred modality for identifying such injuries.
 |
| Blunt abdominal trauma algorithm for step 2 CK |
That's all!
-IkaN
No comments:
Post a Comment
This is express yourself space. Where you type create something beautiful! <3
Wondering what do I write? Well...
Tell us something you know better. You are a brilliant mind. Yes, you are! ^__^
Ask about something you don't understand @_@?
Compliment... Say something nice! =D
Be a good critic and correct us if something went wrong :|
Go ahead. Comment all you like here! (:
PS: We have moderated comments to reduce spam. ALL comments that are not spam will be published on the website.