Pelvic Trauma
Pelvic fractures are important in critical care because they are associated with: High energy mechanisms; Major haemorrhage; Other major injuries; and High morbidity and mortality
Category Trauma
Classification of Pelvic Fractures
There are various systems for classification, these are the 2 most often used: Tile classification and the Young-Burgess classification
Pre-peritoneal packing
Pre-peritoneal packing is a method of directly packing the retroperitoneum without the need for a laparotomy
Pelvic Arterial Injury
Pelvic Arterial Injury: potentially lethal complication of pelvic trauma; more common that previously reported: >10%
Blunt Cardiac Injury
Blunt Cardiac Injury: spectrum from asymptomatic with minor enzyme rises to fulminant cardiac failure
Aortic Injury: Investigation Comparison
Aortic Injury Investigation Comparison: TOE; angiography; CT scan
Pelvic Trauma: Angiography and Embolisation
Pelvic Trauma: Angiography and Embolisation. In centers with interventional radiology capability immediately available these patients may be taken to the angiography suite for embolization
Analgesia in Chest Trauma
Chest trauma is very painful as rest is not possible, pain is experienced with every breath. A multi-modal approach ideal with MDT involvement (ICU, anaesthesia and pain)
Acute Traumatic Spinal Cord Injury
Acute Traumatic Spinal Cord Injury: patient requires synchronous resuscitation, evaluation, treatment and early transfer to a spinal unit following initial stabilisation
Abdominal Trauma: Blunt or penetrating
Assessment of abdominal trauma requires the identification of immediately life-threatening injuries on primary survey, and delayed life threats on secondary survey.
Abdominal CT versus DPL
Abdominal CT versus DPL: DPL has be replaced by FAST scan in nearly all situationspenetrating abdominal injuries -> require laparotomy
Haematuria in trauma
Haematuria in trauma may be microscopic (with or without symptoms) or macroscopic. In general, the greater the degree of hematuria the greater the risk of significant intra-abdominal injury (including non-urinary tract structures)