Trauma

Burn transfer criteria:
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3 mL of lactated Ringer’s solution x weight in kilograms x % of body surface area burned (partial- and full-thickness burns)

Trauma in pregnant pts
–have a low threshold for giving Rhogam

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-types II & III may disrupt cribriform plate – look for CSF rhinorrhea

Traumatic iritis = inflam of ciliary body
-cycloplegic (homatropine. Relieve photophobia) +/- topical steroids (ONLY optho can Rx)

Globe rupture – elevate bed >30′ to reduce ocular pressure and prevent further extravasation (avoid sux if intubating – incr IOP)
-give abx prophyl

Infraorbital anesthesia is associated with this fracture due to injury to the infraorbital nerve. Other findings on physical exam include enophthalmos due to herniation of globe contents before the onset of edema. Diplopia on upward gaze occurs with entrapment of the inferior rectus muscle leading to binocular diplopia 

7 areas of ICH on CT Head: spinal cord, midbrain, 4th ventricle, lateral ventricles, gyri and sulci, gray-white matter differentiation

Spinal shock = cord concussion

3 types of pelvic fractures:
– lateral compression (T-bone MVC/pedestrian hit from side)
—look for vertical fracture of sacrum
—no benefit from pelvic binders
—mostly “elderly” (age >55) pts at risk of bleeding – calcified vessels break easily
—if suspect bleeding or binder already placed, benefits generally outweigh potential harm of overreduction so do not remove
– AP fracture (head on MVC)
– vertical shear (fall)

 

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