Definitely CT Abdo - more sensitive/specific/informative than US or DPL.
Patient has been CV stable for 1 hour and you've already decided to CT her
head/neck/chest so the remote location is less relevant.
Best wishes, Bill
----- Original Message -----
From: "Goat" <[log in to unmask]>
To: "Bill Bailey" <[log in to unmask]>
Sent: Monday, August 25, 2003 10:44 AM
Subject: Trauma room USS
> OK, maybe an old chestnut, but I've had enough politics for a bit - this
> is clinical.
>
> RTA, driver smashed up.
> ? basal skull # with raised ICP.
> best GCS 10 on arrival, very, very agitated.
> left chest injury.
> bruised++ LHS abdo,.
> ETT, lines etc.
> RS and CVS stable for the 1 hr in trauma room.
>
> She is to have a CT head, neck (peg and C7/T1), chest (? mediastinal inj
> on CXR)
>
> In view of abdo bruising and clinical probs assessing belly (sedated,
> ventilated) would you....
>
> 1. ask radiologist to do bedside USS of belly in trauma pre-CT
> 2. add CT belly to other CT requests
> 3. DPL?????
>
> You need to knw that the CT scanner is remote, far from ideal resus
> area, down long corrider, up a lift, over small hill, across a ford etc.
> (10 minutes journey from A&E in same hospital site).
>
> Incidentally, the locum radiologist was extremely helpful and was in
> very early on in proceedings. Let it not be said we don't give praise
> when due!
>
> Goat
>
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