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Log-roll in the trauma bay
Krin135 at aol.com Krin135 at aol.comThu Mar 8 07:12:54 GMT 2007
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In a message dated 3/7/2007 10:59:40 PM Central Standard Time, tch at sun.ac.za writes: The short answer is A before B before C BEFORE D: Log-roll in the context you state is to examine for tenderness over the spines and do a PR for anal tone. These can wait in this situation. The incidence of neurogenic shock is low after lower back fractures - it is classically associated with C3 - T5 injuries and so I would be inclined to go with the surgeon and make sure he has a vascular set open as there may well be an IVC or Aortic injury. If the patient is moving arms and has minimal neck pain go to the OR. Neurogenic shock also usually gives a (relative) bradycardia - you did not provide a pulse-rate??? Some more info would be nice. Let us also have some outcome feedback. My basic attitude on this one is that the surgeon and OR team is going to want the dirty clothes out from under the patient in any case...since the patient needs to be log rolled to accomplish that, the posterior exam and palpation (along with rectal) can be accomplished at that time, without unduly delaying the trip to the OR. ck Charles S. Krin, DO FAAFP <BR><BR><BR>**************************************<BR> AOL now offers free email to everyone. Find out more about what's free from AOL at http://www.aol.com.
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