Trauma is the leading cause of death during the first 4 decades of life, and motor vehicle accidents are usually responsible. If patients survive the accident scene, the first hour and those immediately thereafter are extremely important since many lives can be saved if proper trauma resuscitation protocol is followed. The initial assessment must begin with an evaluation of the patient’s airway, being sure that there is adequate and unobstructed entry of air into the trachea. Bilateral air exchange must be present, absence of this may herald the presence of a pneumothorax or hemothorax. Attention is then turned to assessing the circulation, determining the degree of shock present and instituting the proper fluid resuscitation through large bore peripheral intravenous lines. A neurologic exam is quickly performed followed by a secondary survey of the patient’s body. Initial radiographs include a cervical spine series to visualize all 7 cervical vertebrae, and a chest and pelvic x-ray. The sequence of tests next obtained is determined by level of consciousness, hemodynamic stability, presence of other injuries, and whether surgery is needed for non-abdominal pathology.
KeywordsBlunt Abdominal Trauma Splenic Injury Diagnostic Peritoneal Lavage Splenic Preservation Accident Scene
Unable to display preview. Download preview PDF.