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Adult Trauma Guidelines

Resuscitative thoracotomy

** This topic is available as a learning module on Ko Awatea ** Click HERE to access this course     Introduction  A resuscitative thoracotomy performed in the ED or pre-hosptial setting is a procedure of last resort to save a potentially salvageable patient who has suffered a traumatic cardiac arrest. Read more…
By jSdj2sn7eH, ago

Traumatic cardiac arrest

The mortality from traumatic cardiac arrest (TCA) is high with survival rates ranging between 5.1% – 7.5% (with good neurological outcomes ranging between 2-6%-6.6%).1 Patient with TCA are a heterogeneous group however. Those suffering a TCA as a result of penetrating trauma have been shown to have better survival to Read more…
By jSdj2sn7eH, ago

Burns

  Please discuss any patient with the following criteria with the Regional Burns Unit at Middlemore Hospital (think SPAM):     OR   Any burn which has failed to heal with conservative management after 10 days   OR   Any concerns with a burn injured patient   Ph: 09 276 Read more…
By jSdj2sn7eH, ago

Spinal cord injury

  Spinal cord injury (SCI) is a relatively rare, but potentially devastating diagnosis with life-long consequences. There are approximately 80-130 new cases of SCI in New Zealand per year.1 The majority of patients are males aged 24-45 with 40% of injuries resulting from motor vehicle accidents. Types of spinal cord Read more…
By jSdj2sn7eH, ago

Urethral trauma

Due to anatomical differences, urethral trauma is common in men, but can be seen in women with severe pelvis trauma Suspect urethral injury in patient with Anterior pelvis fractures Straddle injuries Penetrating injuries adjacent to urethra Lateral compression with vaginal vault penetration   Clinical signs Inability to void Haematuria Blood Read more…
By jSdj2sn7eH, ago

Pelvic binders

Pelvic binding is an important adjunct in the management of the trauma patient with a suspected “open book” pelvis fracture (AP compression type injury – see pelvis fracture classification below) – correct application can reduce the bony ends of the fracture decreasing pain and bleeding from injured bone cortex. There Read more…
By jSdj2sn7eH, ago

Pelvis trauma

  Clinical assessment Inspection  Abrasions/contusions over bony prominences Skin integrity, open wounds Scrotal/perineal haematoma Blood at urethral meatus Leg length discrepancy When a significant pelvis injury is suspected, obtain an AP pelvis x-ray to guide examination and treatment   Feel/move Pelvic stressing or ‘springing’ should not be performed as it Read more…
By jSdj2sn7eH, ago

Blunt abdominal trauma

  Background The majority of significant blunt abdominal trauma is sustained in road traffic crashes (50-75% of cases). Falls, sporting injuries and assaults are other leading causes. Mechanisms of injury include Direct blows to the abdomen. Injuries to solid organs from direct force Blunt force can press the abdominal contents Read more…
By jSdj2sn7eH, ago

Primary survey

Introduction The initial management of major trauma has traditionally been taught with an “ABCDE” approach, with the aim to rule out life threats before progressing to the next step. While this might still be appropriate in settings with single physician coverage or limited resources, the primary survey is ideally achieved Read more…
By jSdj2sn7eH, ago

Penetrating abdominal trauma

Most penetrating abdominal trauma in New Zealand occurs from stab wounds. Gun-shot and other missile/projectile injuries present less frequently.1   Penetrating abdominal trauma management algorithm    Management pearls In patients with upper abdominal stab wounds (or any GSW/projectile), haemodynamic instability may be due to pericardial injury or massive haemothorax/tension pneumothorax. Read more…
By jSdj2sn7eH, ago