List Archives

Tue May 31 22:47:02 BST 2005

This fracture is not amenable to wrapping of sheet--there is no volume expansion problem of the pelvis such as with an open book fracture.  This maneuver will be useless to stem bleeding, may just deform the pelvis further.  Pack the open pelvis wound, then up to the OR for quick ex lap to rule out intra-abdominal injury, diverting ostomy and pack pelvis from within --then ex-fix by Ortho in OR.  I would transfer to angio from the OR for embolization of any extravasating vessels--I would do this before ex-fix if patient remained unstable after fixing any ligatable vessel in abdomen.  A suprapubic cystostomy should be done while in the abdomen, do a RUG and cystogram and repair scrotum later when life threatening problems taken care of.
ERF

-----Original Message-----
From: J.C. Goslings <j.c.goslings at amc.uva.nl>
To: trauma-list at trauma.org
Sent: Mon, 30 May 2005 18:38:03 +0200
Subject: Pedestrian struck

This guy just came in:
36 year old male, truck driven over pelvis and abdomen
A: free, stifneck placed
B: normal
C: grade III/IV hypovolemic shock, syst. blood pressure 60, pelvic binder placed 
on scene
D: alert and awake at the scene, now intubated/ventilated
E: open pelvic fracture through rectum and scrotum, multiple severe deglovements 
torso and right leg
chest X-ray: normal
FAST: some free intraabdominal fluid
pelvic X-ray: attached

What would you do?
Thank you,
Carel Goslings and Karine van Scherpenzeel
Trauma Unit AMC
Amsterdam, Netherlands

--
trauma-list : TRAUMA.ORG
To change your settings or unsubscribe visit:
http://www.trauma.org/traumalist.html

Attached Image: Shockroom.JPG 
[Image removed] 
Attached Image: Pelvis.jpg 
[Image removed] 

List Archives

For your convenience, find the Trauma List Archive Below

Pedestrian struck