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Diagnostic Peritoneal Lavage
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Date: Tue, 21 Oct 1997 06:22:18 +0100
From: Dr. Ed Walker [Ed_trauma@limeland.demon.co.uk]
I understand DPL (diagnostic peritomeal lavage) is no longer de
rigeur at ATLS soirees. Is this right?
If so, what has taken its place at the top of the list to do when
dithering about laparotomy?
--
Dr. Ed Walker FRCA
Staff Grade Practitioner, A&E
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Date:
Tue, 21 Oct 1997 08:12:45 -0400
From: Smith, J. Stanley, MD [JStanley.Smith@hmc.psu.edu]
DPL is still taught and is a necessary skill. Ultrasound has been
added.
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Date: Tue,
21 Oct 1997 14:57:26 -0400 (EDT)
From: Andrew Glantz [AndyGlantz@aol.com]
DPL remains the gold standard for the evaluation of the hemodynmically
unstabl e patient. Bedside 4-quadrant ultrasound has recently been
suggested. CT scan remains the gold standard for the hemodynamically
stable patient.
Andrew Glantz, MD, FACS, FCCM
Easton, PA
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Date:
Wed, 22 Oct 1997 21:42:20 +0100
From: Dr. Ed Walker [Ed_trauma@limeland.demon.co.uk]
Trouble is a litre of warm saline sloshing around your peritoneum
does nothing at all for the quality of US images....
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Date:
Thu, 23 Oct 1997 10:38:11 -0500
From: Dennis Hudson, R.N. [dhudson@ahecpb.uams.edu]
One would hope that if you had access to emergent/ bedside US,
you would do that before/instead of DPL....
If someone with a "liter of warm saline sloshing around your peritoneum"
has a seizure, can you hear the splash ? hmmmmmmmmm
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Date:
Thu, 23 Oct 1997 22:38:40 +0200
From: Paran Haim [paran620@green.co.il]
An Abdominal US donne by the attending trauma surgeon, or if he
has no enough experience by the radiologist (2 minutes away), is
the routine in our ER. The remaining of the saline in the peritoneal
cavity can also interfere with the eventual CT interpretation.
Haim Paran
Dept of Surgery A
Meir Hospital
Kfar-Sava
Israel
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Date:
Sat, 25 Oct 1997 17:37:44 -0500
From: Douglas Geehan [dgeehan@cctr.umkc.edu]
Just as an aside. For those who are still learning (or those who
aren't), doing an abdoimnal ultrasound after a DPL is a great teaching
tool. Having a known positive exam helps to hone skills, and the
majority of the studies that are done clinically are negative. Patients
with ascites or on CAPD are also good known positives.
--
Douglas Geehan, MD
Assistant Professor
Department of Surgery
UMKC
Kansas City, MO 64108
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