Trauma Cases - Dr. Gibbs

Traumatic Brain Injury Management

• Avoidance of secondary injury by aggressive airway management and maintenance of CNS perfusion.
• ICP control with mannitol and reserve hyperventilation for clear signs of herniation.
• CT imaging if on Warfarin OR Plavix.
• Early Reversal is part of resuscitation.

Blunt Aortic Injury

• Know the Chest X-Ray findings associated with blunt aortic injury.
• CT is the Gold Standard for definitive diagnosis and TEE can be helpful.
• Injury Staging is important.
• Blood pressure control if definitive management is delayed.

Pelvic Fractures

• Pelvic ring fractures are associated with major hemorrhage, especially when pelvic volume is increased (ex, open-book fractures).
• Know plain film classification.
• Early pelvic stabilization save lives.
• Angiographic embolization when arterial injury is suspected!

Penetrating Neck Trauma

• External findings may be minimal.
• Immediate airway and hemorrhage controlling the unstable patient.
• Know the three zones of the neck, as this will clarify your diagnostic strategy.

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