No haemodynamically unstable patient should be taken to the CT scanner.
scenario016
No haemodynamically unstable patient should be taken to the CT scanner.
There is no intraperitoneal haemorrhage to account for this degree of shock (FAST scan negative). Laparotomy is only used in this situation to control haemorrhage from intra-abdominal solid organ or vascular injury. Attempts to open the retroperitoneum and control pelvic haemorrhage are invariably futile and often lead to death on the table.
Angiography is the best way to control pelvic arterial haemorrhage. Temporary slings or splints should control bleeding from bone surfaces and most venous haemorrhage. On-going haemorrhagic shock should be treated with angiographic embolisation.