Log-roll in the trauma bay

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Was there an event prior to the fall ?

A. Caruso EMT-P

>From: "Hardcastle, Tim, Dr <tch at sun.ac.za>" <tch at sun.ac.za>
>Reply-To: "Trauma &amp; Critical Care mailing list" 
><trauma-list at trauma.org>
>To: "Trauma &amp; Critical Care mailing list" <trauma-list at trauma.org>
>Subject: RE: Log-roll in the trauma bay
>Date: Thu, 8 Mar 2007 06:58:52 +0200
>
>Jacob
>
>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.
>
>Tim
>Dr T C Hardcastle
>M.B.,Ch.B.(Stell); M.Med(Chir); FCS(SA)
>Senior Surgeon / Senior Lecturer: Surgery (Trauma and ICU)
>ATLS  instructor and DSTC Cape Town Course Director
>Intern program Coordinator: Surgery
>M.Med (Emergency Medicine) Executive Committee member
>Clinical Head (Director): Diana Princess of Wales Trauma Unit
>Division of Surgery (General) Room 4064
>Department of Surgical Sciences
>Tygerberg Hospital / University of Stellenbosch
>PO Box 19063
>Tygerberg 7505
>Western Cape
>South Africa
>e-mail: tch at sun.ac.za
>Cell: +27824681615
>Office: +27219389281 or 4911 pager 0302
>
>
>
>-----Original Message-----
>From: trauma-list-bounces at trauma.org
>[mailto:trauma-list-bounces at trauma.org]On Behalf Of Jacob Scholtz
>Sent: Wednesday, March 07, 2007 8:13 PM
>To: trauma-list at trauma.org
>Subject: Log-roll in the trauma bay
>
>
>A patient is brought into your trauma-bay after a from a building. He has a
>neck-collar, but the rest of his spine has not been immobilised. He is
>in respiratory distress. The airway is clear. Breath-sounds are present
>bilaterally. Saturation 99% with 10 L O2. Blood pressure 65/-. His abdomen
>is tender. He has no obvious open injuries to the thorax, abdomen or
>extremities. Fluids are given, but the blood pressure does not improve
>significantly. The surgeon wants the patient brought to the OR for a
>laparotomy. The patient is complaining of pain from the lower back, the
>abdomen and his legs bilaterally. Would you log-roll the patient before
>bringing him to the OR?
>
>Jacob
>--
>trauma-list : TRAUMA.ORG
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