List Archives

Tue, 10 Jun 2003 20:29:58 -0400

"More accurate"!?!?! Based on what?

-----------------------
William M. Coplin, MD
Associate Professor, Neurology & Neurological Surgery
Wayne State University
Chief, Neurology; Medical Director, Neurotrauma & Critical Care
Detroit Receiving Hospital

> ----------
> From: 	ecthompson
> Reply To: 	ecthompson@msn.com
> Sent: 	Tuesday, June 10, 2003 19:52
> To: 	trauma-l@lists.aast.org; trauma-list@trauma.org; =
ccm-l@list.pitt.edu
> Subject: 	RE: Wheelie @100 mph
>=20
> There were several papers presented at this year> '> s EAST which =
looked at the best way to evaluate the spine.  All the papers concluded =
that computed tomograms were quicker, easier and more accurate than =
plain films.
> =20
> E
> =20
> Errington C. Thompson, MD
> Trauma Surgeon
> Trinity Mother Frances
> Tyler, Tx
> ecthompson@tyler.net
> =20
> Don't think you are
> Know you are
>                             - Morpheus (The Matrix)
> =20
> -----Original Message-----
> From: rafaelgrossmann [mailto:rgrossz@cantv.net]=20
> Sent: Tuesday, June 10, 2003 11:22 AM
> To: trauma-l@lists.aast.org; trauma-list@trauma.org; =
ccm-l@list.pitt.edu
> Subject: RE: Wheelie @100 mph
> =20
> I would be very concern about the possibility of thoracic-lumbar spine =
injuries. There is no way to r/o those with such distracting injuries, =
even with a mega radiological workup, but I would at least try to do TLS =
series to r/o obvious gross abnormalities.=20
> With such pelvis injuries Lovenox is probably a little too bold =
initially> ...> the SCD> '> s sound smart and safer than Lovenox.=20
> No open fractures, no antibiotics> ...> just > "> old> '>  soap and =
water> ">  for the rash! What would you be treating or preventing by =
using them?
> To ortho when safe, and when you would feel > "> easy> ">  if he was =
your brother and the orthopods would be treatig him> ...>=20
> He is lucky he did not injure anyone else. Needs a good talk =
re.ETOH/Helmet issues.
> =20
> Best regards,
> Rafael J. Grossmann, MD
> "> Z> ">=20
> From the sunny beaches of Venezuela> ...>=20
> =20
> =20
> =20
> -----Original Message-----
> From: KMATTOX@aol.com [mailto:KMATTOX@aol.com]=20
> Sent: Tuesday, June 10, 2003 8:45 AM
> To: trauma-l@lists.aast.org; trauma-list@trauma.org; =
ccm-l@list.pitt.edu
> Subject: Wheelie @100 mph
> =20
> We have an interesting ongoing case
>=20
> 46 year old man loves to ride and race his  motorcycle.   A few nights =
ago he was racing with a friend and going 100 mph.   He was wearing =
shorts, sandals, and no helmet.    He popped a wheelie to demonstrate =
his ability to do so, but when the motorcycle came down, the front wheel =
came down the back of a Honda car traveling considerably slower.   He =
encountered the pavement for about 40 yards and the ambulance was =
called.   =20
>=20
> He arrived with a GCS of 15, but with the smell of ETOH on his  =
breath, road rash on scalp, both arms, both legs, back, and shoulders.   =
Apparent fractures of both forearms and pelvis appeared unstable.   BP =
140/70, P 84, R 20.   O2 Sat by pulse Oxymetry 100.   Chest X-ray =
basically normal.  Orthopedic X-Rays confirmed wide open book fx of =
pelvis, Fx of both wrists.   C-Spine cleared.   FAST normal.   Admitted =
to trauma service with plans for orthopedic surgery to fix his bones =
ASAP in OR.   =20
>=20
> So, I guess the questions at this point include:
>=20
> Choice of antibiotics if any
> Choice of DVT prophylaxis if any
> Timing of orthopedic repairs if any
> When to sign him off to the orthopedic service.=20
>=20
> k =20
>=20

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Wheelie @100 mph