Prompt

A 40-year-old in a motor vehicle crash has the hypotension (SBP 85 responding to fluids), the FAST positive, and the abdominal tenderness. Discuss the assessment and management.

Question

A 40-year-old in a motor vehicle crash has the hypotension (SBP 85 responding to fluids), the FAST positive, and the abdominal tenderness. Discuss the assessment and management.^[1]

References7Show

[1]Smyth L, et al. WSES guidelines on blunt and penetrating bowel injury: diagnosis, investigations, and treatment. World J Emerg Surg, 2022.PMID 35246190
[2]Stassen NA, et al. Selective nonoperative management of blunt splenic injury: an Eastern Association for the Surgery of Trauma practice management guideline. J Trauma Acute Care Surg, 2012.PMID 23114484
[3]Holcomb JB, et al. Transfusion of plasma, platelets, and red blood cells in a 1:1:1 vs a 1:1:2 ratio and mortality in patients with severe trauma: the PROPPR randomized clinical trial JAMA, 2015.PMID 25647203
[4]Shakur H, Roberts I, Bautista R, et al. Effects of tranexamic acid on death, vascular occlusive events, and blood transfusion in trauma patients with significant haemorrhage (CRASH-2): a randomised, placebo-controlled trial Lancet, 2010.PMID 20554319
[5]Rotondo MF, et al. 'Damage control': an approach for improved survival in exsanguinating penetrating abdominal injury. J Trauma, 1993.PMID 8371295
[6]Rossaint R, et al. The European guideline on management of major bleeding and coagulopathy following trauma: sixth edition. Crit Care, 2023.PMID 36859355
[7]Roberts I, Shakur H, Afolabi A, et al. The importance of early treatment with tranexamic acid in bleeding trauma patients: an exploratory analysis of the CRASH-2 randomised controlled trial. Lancet, 2011.PMID 21439633

Question

A 40-year-old in a motor vehicle crash has the hypotension (SBP 85 responding to fluids), the FAST positive, and the abdominal tenderness. Discuss the assessment and management.^[1]

References7Show

[1]Smyth L, et al. WSES guidelines on blunt and penetrating bowel injury: diagnosis, investigations, and treatment. World J Emerg Surg, 2022.PMID 35246190
[2]Stassen NA, et al. Selective nonoperative management of blunt splenic injury: an Eastern Association for the Surgery of Trauma practice management guideline. J Trauma Acute Care Surg, 2012.PMID 23114484
[3]Holcomb JB, et al. Transfusion of plasma, platelets, and red blood cells in a 1:1:1 vs a 1:1:2 ratio and mortality in patients with severe trauma: the PROPPR randomized clinical trial JAMA, 2015.PMID 25647203
[4]Shakur H, Roberts I, Bautista R, et al. Effects of tranexamic acid on death, vascular occlusive events, and blood transfusion in trauma patients with significant haemorrhage (CRASH-2): a randomised, placebo-controlled trial Lancet, 2010.PMID 20554319
[5]Rotondo MF, et al. 'Damage control': an approach for improved survival in exsanguinating penetrating abdominal injury. J Trauma, 1993.PMID 8371295
[6]Rossaint R, et al. The European guideline on management of major bleeding and coagulopathy following trauma: sixth edition. Crit Care, 2023.PMID 36859355
[7]Roberts I, Shakur H, Afolabi A, et al. The importance of early treatment with tranexamic acid in bleeding trauma patients: an exploratory analysis of the CRASH-2 randomised controlled trial. Lancet, 2011.PMID 21439633

Blunt abdominal trauma — FAST, CT, and the non-operative vs laparotomy

Question

Blunt abdominal trauma — FAST, CT, and the non-operative vs laparotomy

Question