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In what situations would u go an exp laparotomy and a diagnostic peritoneal lavage?
example: In a patient with a gun shot wound and a stab wound u do exp lap.....
But in a blunt trauma would u do diagnostic peritoneal lavage or exp lapa if the patient is stable or unstable?
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all gun shot wounds below the nipple do exp laporotomy!thast the rule!!!
if pt has blunt trauma exp lapo if pt is unstable and u know for sure he is haemorrhaging and in shock.if pt is stable but u suspect bleeding[like periumb discolouration etc etc]do dpl.pt stable and u dont think he had a major bleeder inside[pts vitals remain stable over time then wait and watch.
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stab wound u can follow as in blunt trauma but here 1st step is put ur finger in the stab wound and explore it to see if it has penetrated into peritoneum
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any gun shot on the abdomen you next step is exp laparatomy stable or unstable.
If the patient has a satb wound and is stable you will do anything only ABC and look and if the patient is unstable ABC and the exploration of the wound with digital examination and the US or DPL.
when you have a patient with blunt trauma and the patient is unstable you next step is DPL or US after you ABC.
If the patient has a blunt trauma and he or she is stable you next step is ABC and then CT scan.
Remember you will never do a surgery if you dont know where is the lesion.
