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Fri Sep 7 06:23:08 BST 2007

Rob

Basics - CXR; to exclude the need for chest tube (what were the lung sounds / percussion??)
FAST sonar for heart - would watch with resonar 6hrly any effusion less than/= to 5mm.

Nil else - short stay ward. Regular clinical review.

85% of these are home in 24 hours.

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 Robert F. Smith
Sent: Friday, September 07, 2007 3:38 AM
To: 'Trauma &amp; Critical Care mailing list'
Subject: RE: 2D or 3D TEEin penetrating cardiac injury No NO 

Ok so you have an 18 yr old male presenting with a stab wound over the
precordium. His pulse is 90, BP 110/70, RR 18. No retained missile. Would
you do any diagnostic studies and why and what findings would you take
action on?

Rob

-----Original Message-----
From: trauma-list-bounces at trauma.org [mailto:trauma-list-bounces at trauma.org]
On Behalf Of KMATTOX at aol.com
Sent: Thursday, September 06, 2007 9:19 PM
To: trauma-list at trauma.org
Subject: Re: 2D or 3D TEEin penetrating cardiac injury No NO 

In a message dated 9/6/2007 8:14:04 P.M. Central Daylight Time,  
rfsmithmd at comcast.net writes:

3. With  appropriate mechanism, and a positive finding on FAST, what
clinical
findings are you going to wait to  see?

A patient with symptoms that matches the positive image seen on the  FAST.

It is ludicrous to operate on a patient that does  not need an operation,
put 
a stent graft in a patient without a vascular lesion,  etc.  

VOMIT.    Treat and OPERATE on a patient NOT an  image.   The image test is 
just a something to aid in  diagnosis.    

k 

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2D or 3D TEEin penetrating cardiac injury No NO