Digital Rectal Exam (DRE) in Trauma
Traditional ATLS teaching was that a digital rectal exam (DRE) is mandatory in trauma patients: “a finger or tube in every orifice”. This is no longer the case.
Major Haemorrhage in Trauma
Major Haemorrhage in Trauma
Damage Control Resuscitation
Damage control resuscitation (DCR) is a systematic approach to the management of the trauma patient with severe injuries that starts in the emergency room and continues through the operating room and the intensive care unit (ICU). DCR involves haemostatic resuscitation, permissive hypotension (where appropriate) and damage control surgery
Kidney trauma
Most genitourinary injuries are not immediately life-threatening. Renal pedicle injury can lead to life-threatening hemorrhage and renal ischemia
Spleen trauma
Splenic trauma may result from blunt or penetrating abdominal injury. The spleen is the most commonly injured organ in blunt abdominal trauma
Diaphragm injury
Diaphragmatic injury can be a challenging diagnosis and is missed on imaging about 50% of the time. Comprises 0.8 to 8% of all closed blunt trauma and penetrating trauma case combined
Liver trauma
Liver trauma may result from blunt or penetrating abdominal injury. The liver is the most commonly injured organ in penetrating abdominal trauma
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
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