GUNSHOT WOUND THROUGH BOTH THIGHS

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Ankle-brachial index

Take the systolic blood pressure in the arm and divide that by the
systolic pressure in the leg.

If there is an injury to both legs couldn't both ABI's be abnormal?

Normally I would simply explore an injury but injuries around the knee may
take some planning and creative positioning of the patient.  Agram.

E

Errington C. Thompson, MD
Trauma/Surgical Critical Care
Author - A Letter to America
www.erringtonthompsonmd.com
ecthompson at tyler.net

Everyone deserves to make an informed decision
                                              - Errington C. Thompson, MD


-----Original Message-----
From: trauma-list-bounces at trauma.org
[mailto:trauma-list-bounces at trauma.org] On Behalf Of Paul Middleton
Sent: Saturday, January 29, 2005 4:19 PM
To: 'Trauma & Critical Care mailing list'
Subject: RE: GUNSHOT WOUND THROUGH BOTH THIGHS

I have trouble with abbreviations - What's an ABI?
Paul




Dr Paul M Middleton
RGN MBBS FRCS(Eng) DipIMCRCS(Ed) FFAEM FACEM

Conjoint Senior Lecturer in Emergency Medicine, UNSW
Emergency Physician, Prince of Wales Hospital
Sydney
NSW


-----Original Message-----
From: trauma-list-bounces at trauma.org
[mailto:trauma-list-bounces at trauma.org]
On Behalf Of SJASMD at aol.com
Sent: Sunday, 30 January 2005 7:03 AM
To: trauma-l at lists.aast.org; trauma-list at trauma.org
Subject: GUNSHOT WOUND THROUGH BOTH THIGHS

23 year old man sustained one gunshot wound during interaction with NYPD.

Patient presented with a gunshot that penetrated the left suprapatellar
area

from left to right then entered and exited the right thigh. On admission
he
was
hemodynamically stable. Initial physical exam revealed a black male with
in
and  out holes in each thigh. There were no hematomas, no history of major

bleed at  the scene and slightly diminished pulses in the right foot. When
the
trauma  resident examined the patient shortly thereafter, pulses were
markedly
diminished to absent. A few minutes later the attending assessment was
that
the
 pulses were dminished but present.
An arteriogram was requested and set up. By the time the team was ready to

begin the angio, the pulses were totally normal.

Would you do an arteriogram on this patient with normal pulses?
Do you rely on ABI to screen for vascular injury

sal
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