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Mon, 14 Oct 2002 16:48:26 -0700 (PDT)

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whoever told you that angio does not see prox aorta injuries prob isn't trauma radiologist or trauma surgeon...and these are the experts. it does show prox injuries and is best to see.  if you treat blunt trauma, you should have fast angio capabilities or you are doing pt a disservice.
 Andrew J Bowman <sumieb@compuserve.com> wrote:Trauma List

As promised, more of the story.

42 year old male, motorcycle driver, hit a truck broadside at an
intersection.  Head injury and multiple, open extremity fractures.

Multiple area CT's including of chest.  2 views of chest CT are attached
which are the areas of interest.  Read by at least 2 radiologists and the CV
surgeon. Scanner is a new GE "light speed"

Official reading is as follows: "there is an identified irregularity of the
ascending aorta with the suggestion of a short segment dissection"

The study was repeated through this area and was again visualized as a
possible intimal flap dissection

No angiography, no TEE.

Pt was transferred from my ED to another hospital across town where pump
capability is located.

Median sternotomy was done.  Aorta explored.  No abnormality found.

Chest closed and attention turned to extremity injuries.  Pt did well.

I hope the CT quality is OK.  I got copies and then had to scan them in.

I had made the suggestion of doing an angio but was poo-pooed by all
involved.

Was told proximal aorta injuries are not seen well on angio.  Oh well.  It
appears they are seen too well with CT, so well they do not even have to be
there!

Andrew J. Bowman, RN, CEN, CCRN, NREMT-P
Patient Care Coordinator
Education Coordinator (Trauma & Emergency Cardiovascular Care)
Emergency Department
Home Hospital Campus
Greater Lafayette Health Services, Inc.
Home Hospital Campus
Lafayette, Indiana  47904
USA> ATTACHMENT part 2 image/jpeg name=False flap 2.jpg > ATTACHMENT part 3 image/jpeg name=False flap 1.jpg 

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<P>whoever told you that angio does not see prox aorta injuries prob isn't trauma radiologist or trauma surgeon...and these are the experts. it does show prox injuries and is best to see.&nbsp; if you treat blunt trauma, you should have fast angio capabilities or you are doing pt a disservice.
<P>&nbsp;<B><I>Andrew J Bowman &lt;sumieb@compuserve.com&gt;</I></B> wrote:
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<DIV>Trauma List<BR><BR>As promised, more of the story.<BR><BR>42 year old male, motorcycle driver, hit a truck broadside at an<BR>intersection.&nbsp; Head injury and multiple, open extremity fractures.<BR><BR>Multiple area CT's including of chest.&nbsp; 2 views of chest CT are attached<BR>which are the areas of interest.&nbsp; Read by at least 2 radiologists and the CV<BR>surgeon. Scanner is a new GE "light speed"<BR><BR>Official reading is as follows: "there is an identified irregularity of the<BR>ascending aorta with the suggestion of a short segment dissection"<BR><BR>The study was repeated through this area and was again visualized as a<BR>possible intimal flap dissection<BR><BR>No angiography, no TEE.<BR><BR>Pt was transferred from my ED to another hospital across town where pump<BR>capability is located.<BR><BR>Median sternotomy was done.&nbsp; Aorta explored.&nbsp; No abnormality found.<BR><BR>Chest closed and attention turned to extremity injuries.&nbsp; Pt did well.<BR><BR>I hope the CT quality is OK.&nbsp; I got copies and then had to scan them in.<BR><BR>I had made the suggestion of doing an angio but was poo-pooed by all<BR>involved.<BR><BR>Was told proximal aorta injuries are not seen well on angio.&nbsp; Oh well.&nbsp; It<BR>appears they are seen too well with CT, so well they do not even have to be<BR>there!<BR><BR>Andrew J. Bowman, RN, CEN, CCRN, NREMT-P<BR>Patient Care Coordinator<BR>Education Coordinator (Trauma &amp; Emergency Cardiovascular Care)<BR>Emergency Department<BR>Home Hospital Campus<BR>Greater Lafayette Health Services, Inc.<BR>Home Hospital Campus<BR>Lafayette, Indiana&nbsp; 47904<BR>USA</DIV>&gt; ATTACHMENT part 2 image/jpeg name=False flap 2.jpg &gt; ATTACHMENT part 3 image/jpeg name=False flap 1.jpg </BLOCKQUOTE><p><br><hr size=1>Do you Yahoo!?<br>
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