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VOMIT - Victim of Modern Imaging Technology

Sanjay Gupta sanjaygupta99_91 at yahoo.com
Tue Aug 23 20:12:23 BST 2011

What I can figure out after all these discussions is - 
Trauma patient arrives, do not put in a line and certainly do not give crystalloids.  I am not sure about giving blood and if we do give blood - do we draw a specimen to cross-match or not.  Maybe a chest x-ray will help.  If something is clinically obvious fix it.  If the patient is hypotensive - do some surgery based on clinical exam and chest x-ray.  And if the patient is hypotensive - again do not put in a line - open the abdomen first, do something and then see if a line will help.  
If not in shock - I am not clear what to do - Whether send the patient home or admit and observe his pulse, blood pressure and GCS?  or there is something else that needs to be done.  
Never do a CT scan because 80% are useless - I thought the purpose of CT scan is to figure out the 20% in which it would be useful.  If we all knew the 80% in whom the CT will not be useful and also the 20% in which it would be useful, I guess the scan will not be done in anyone - I thought a CT scan is a diagnostic test - not to prove your clinical diagnosis. 
Oh yes - you pick up VOMIT with CT scan.  Great acronym, makes you sound very smart. 

Sanjay Gupta

From: caesar ursic <cmursic at gmail.com>
To: Trauma-List [TRAUMA.ORG] <trauma-list at trauma.org>
Sent: Tuesday, August 23, 2011 1:58 PM
Subject: Re: VOMIT - Victim of Modern Imaging Technology

*The, Dr. Mattox, you must be placing great faith in the sensitivity of the
supine AP portable chest x-ray to rule-out a thoracic aortic or great vessel
traumatic pseudoaneurysm.*

C. Ursic, MD

On Mon, Aug 22, 2011 at 9:30 AM, <KMATTOX at aol.com> wrote:

> I know of almost NO indications for an ACUTE CT OF THE CHEST following
> chest trauma, especially blunt chest trauma.        Mediastinal traverse
> following GSW,  maybe, depending on the finding of the  initial plain chest
> X-ray.
> k
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