I'm not sure I can walk

 

This SAQ is worth 11 marks

A 56 year old man has been brought to your tertiary ED after a motorcycle accident.
His pelvic Xray is given.

View attached:  Attachment 1

Question 2.
Classify his pelvic injury based on the Xray provided. (2 marks)


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Question 2.
List 4 possible methods of arresting the blood loss from his pelvic injury. (4 marks)


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2._________________________________________________________________________________________________

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Question 1.

CT scans have revealed active arterial haemorrhage related to his pelvic injury, but no other obvious injuries.

His vital signs are:

GCS 14 E4 V4 M6

Pulse 135 /min

BP 70/40 mmHg

O2 saturation 98% 6L O2 via mask

Temp 36.5 degrees

In point form, list your principles of his fluid resuscitation while he is awaiting definitive management of his pelvic injury. 

(5 marks)


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This SAQ is worth 11 marks

A 56 year old man has been brought to your tertiary ED after a motorcycle accident.
His pelvic Xray is given.

Question 2.
Classify his pelvic injury based on the Xray provided. (2 marks)

Grade 3 antero-posterior compression fracture of the pelvis (right side)

Question 2.
List 4 possible methods of arresting the blood loss from his pelvic injury. (4 marks)

  • Pelvic binder
  • interventional radiology
  • pelvic packing in OT
  • ORIF in OT

Pass 3/4



Question 1.

CT scans have revealed active arterial haemorrhage related to his pelvic injury, but no other obvious injuries.

His vital signs are:

GCS 14 E4 V4 M6

Pulse 135 /min

BP 70/40 mmHg

O2 saturation 98% 6L O2 via mask

Temp 36.5 degrees

In point form, list your principles of his fluid resuscitation while he is awaiting definitive management of his pelvic injury. 

(5 marks)

  • Minimal volume resuscitation
    • Targets: systolic BP 80mmHg, radial pulse, mentation
  • Use blood products, minimal crystalloid
    • Initially O neg then Xmatched
    • Initiate massive transfusion protocol early
    • Aim packed cells:FFP:platelets 1:1:1 ratio (targeted to ROTEM acceptable)

Each point 1 mark but has to show clinical reasoning

 

Total pass 7/11 corrects to 6/10




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pelvis   xray   x-ray   pelvic   fracture   haemorrhage