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Unstable trauma patient
↓
Exam of the thigh compartments,CXR, FAST/DPL, AP pelvic radiograph
↓
+ FAST →laparotomy
− FAST, + pelvic fracture →
angiography.
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Bladder injuries-
1-Gross hematuria is almost always present.
2-CT cystogram demonstrates intra- or extra-peritoneal leak.
3-Manage extraperitoneal injuries with urinary catheter drainage (2–3 weeks);
i4-ntraperitoneal injuries require immediate repair.
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ANKLE-BRACHIAL INDEX
SBP at the ankle/SBP the brachial artery. Ankle-brachial index (ABI) ≥ 1 →
normal. ABI 0.5-1 → moderate disease. ABI < 0.5 → severe disease. Highly
calcified vessels are noncompressible, so ABI is falsely high. Important clinical
correlations can be made based on ABI values:
■ ABI 0.5–0.7: Claudication
■ ABI 0.3–0.5: Rest pain
■ ABI < 0.3: Gangrene
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PULSE VOLUME RECORDING
Also known as plethysmography. Measures dynamic volume changes of a
limb. Assesses presence or absence of pulsatile blood flow. Does not depend
on compressibility of vessels and, therefore, is particularly useful in patients
with calcified vessels