Post by Dr. Natalie Pasteur on Dec 29, 2009 12:39:07 GMT -5
Here are the rules for assessing internal bleeding of the abdomen, and I have seen some of the best surgeons miss these. Don't rely just on your scans. The patient's body is trying to tell you something. Surgical gods and goddesses[/b][/color] don't miss the body's clues.
σ Bruising or discoloration
Σ Palpable mass, liver border palpated, spleen palpated
ω Pain and tenderness
ψ Swelling
φ Firmness/thud on percussion
Φ Loss of bowel sounds
Σ Loss of urine flow or blood in the catheter (Catheterize your traumas, people, unless contraindicated)
ρ Blood pressure dropping
π Heart rate is increasing and Hemoglobin or Hematacrit is low or dropping.
Always resolve with an ultrasound study or CT, never "Old School It" by performing a pericentesis solely for the purpose of diagnostics: Why?
That's right! Infection, unneccesary scarring, and hey, you just created a new spot to start bleeding from, especially if you miss.(aka perforate something)
σ Bruising or discoloration
Σ Palpable mass, liver border palpated, spleen palpated
ω Pain and tenderness
ψ Swelling
φ Firmness/thud on percussion
Φ Loss of bowel sounds
Σ Loss of urine flow or blood in the catheter (Catheterize your traumas, people, unless contraindicated)
ρ Blood pressure dropping
π Heart rate is increasing and Hemoglobin or Hematacrit is low or dropping.
Always resolve with an ultrasound study or CT, never "Old School It" by performing a pericentesis solely for the purpose of diagnostics: Why?
That's right! Infection, unneccesary scarring, and hey, you just created a new spot to start bleeding from, especially if you miss.(aka perforate something)
