List Archives

Sun Mar 20 08:43:54 GMT 2005

In the UK on occasions patients have been taken to the CT scanner at
Newmarket. This is a horseracing centre, so the scanner is horse sized -
therefore has a higher weight limit.

Dr NJD Macartney FRCA
ICU, Chase Farm Hospital, Enfield, Middlesex
EN2 8JL
+447831 630068 Mobile
+4420 83751955 ICU

> -----Original Message-----
> From: trauma-list-bounces at trauma.org
> [mailto:trauma-list-bounces at trauma.org]On Behalf Of Shawn Mawhinney
> Sent: 19 March 2005 18:45
> To: trauma-list at trauma.org
> Subject: Investigating the Morbidly Obese Trauma Patient
>
>
> Investigating the Morbidly Obese Trauma Patient
>
> I am a TTL in Canada and recently had a very large patient that I
> could not
> investigate because of his size.  The patient was a 34 y/o male
> who was the
> driver of a vehicle that was broadsided by a truck in a remote
> area.  It took
> almost 20 hours to get him to our facility.  His most serious
> obvious injury
> was a severely mangled left arm.  He had been sent to us from a
> smaller trauma
> centre that did no radiologic investigations but inserted IV and arterial
> access and referred him to our facility.
>
> Fortunately for the us and the patient, he was awake and alert and
> hemodynamically stable.  He had been given 5 units of blood and
> 22 units of FFP
> from his sending institution and when he arrived his HR was 100, BP 100
> systolic and hgb 116.  However considering the impact I wanted to
> assess his
> chest and abdomen.  The CXR was very poorly penetrated and
> non-diagnostic.  The
> FAST was also unhelpful.  We were unable to fit him through our
> CT scanner.
> Clinical exam would be best but he was about to undergo surgery for an
> undetermined length of time and likely end up in the ICU intubated.
>
> I wondered if other facilities have had problems like this and what their
> approach is to these patients?  How do they investigate?  Would
> anyone do a
> DPL, or wait and follow his hgb/hct and if he required blood
> products then
> operate?  Are there CT scanners that can handle heavier patients?
>
> Thanks,
>
> Shawn
>
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Investigating the Morbidly Obese Trauma Patient