Orthopaedic Trauma
Management
Source
Dr David Penn 2014
- DRSABCDE
- Exposure (Check for life-threatening injury) = Head, C-spine, chest = pneumothorax + tamponade, Abdo = ? acute abdomen, Pelvis = Open book pelvic fracture (bleeding from urethra, bruise, scrotum haematoma, sphincter tone), Spine = roll over to look, Limbs = pulse, ?nerve supply
- Need catheter? NO if pelvic trauma - if high riding prostate, urethra is ruptured. Call urology.
- IV: N saline, pain relief (Morphine 0.1mg/kg) + Ondansetron
- Ix: FBC (Hb), CRP. UEC (renal), blood x-match
- Meds: Cephalosporin (GP), Gent (GN), Metronidazole (anerobe), Penicillin (C. perfringens) Tetanus
- Injury: If pt stable, ? open/ close. If open: Sterilise --> Splint -->
- Imaging: AP/ lat view of joint above + below. Trauma series (C-spine, chest, pelvic)
- Refer: ortho
- Ortho will do: 2o survey (chest, abdo, limbs)
Source
Dr David Penn 2014