Abdo Trauma

Question 1

If a high level of suspicion of intrabdominal injury exists, what is the preferred scan of choice?

Answer 1

CT scan (commutated tomography)

Question 2

What should be considered with regards to the risk of false negative results for FAST scan?

Answer 2

Where there is a high index of suspicion for injury, other causes should be considered for a negative scan; e.g. centralised circulation or limited arterial perfusion of injured solid organs

Question 3

What are some of the negatives of a FAST scan in trauma?

Answer 3

Quality of assessment is operator dependent
Not able to detect volumes of fluid less than 200mls so the potential of missed visceral injury or delayed diagnosis

Question 4

What are the main drivers for using FAST in trauma?

Answer 4

Economic benefits, non-invasiveness and the repeatability of examinations

Question 5

What is a FAST scan?

Answer 5

Focused assessment with sonography in trauma, looking for the presence of blood

Question 6

Why is FAST scan used in trauma?

Answer 6

It allows for immediate assessment of the trauma patient because of its ability to detect splenic and hepatic injuries

Question 7

What are the 4 areas that the FAST is used for in trauma patients?

Answer 7

Pericardial space
Perihepatic space
Perisplenic space
Pelvic space

Question 8

What are the indications for urinary catheterisation?

Answer 8

HOUDINI

Hematuria
Obstruction
Urological surgery
Decubitus ulcer
I&O unwell patient
No code/comfort care
Immobility from unstable fractures

Question 9

What is the expected urine output for an adult patient?

Answer 9

20-30 mls per hour