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Fri Oct 12 04:04:06 BST 2007

In a message dated 10/11/2007 9:59:08 P.M. Central Daylight Time,  
roydanks at hotmail.com writes:

Chest  and pelvis is taken and up in ....oh, 3 to 5 minutes from when they 
hit the  door (that's most of K's time gone)...and the pt has bilat pneumos and 
an  openbook pelvis fx...where to now?  OR?   ICU?

Ideally this patient would go to ONE location where chest tubes and a  pelvic 
intervention can be done.   I am no longer certain what  the pelvic 
intervention should be.   I am NOT happy with external  fixators.    I am not sure that 
arteriography is as good as it is  cracked out to be.   I am watching the 
literature on extraperitoneal  packing very closely and am impressed that it is 
indicated in the appropriately  selected case.      I am not sure that 
arteriographic  embolization does anything for the majority of the venous bleeding in 
pelvic  fractures, except buy time.        

k

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