《宠物急诊抢救》腹部创伤的急诊.ppt

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2024-12-02 发布于浙江
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《宠物急诊抢救》腹部创伤的急诊.ppt

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ManagementofAcuteAbdominalTrauma

OutlineIntroductionDiagnosisTreatmentConclusion

IntroductionIncidenceincatsisunknown

IntroductionManycausestoacuteabdominalinjurySomeareeasytodiagnoseandsomecanbeverychallengingPrincipalcausesBlunttrauma(automobileorfall),penetratinginjury(gunshotwoundorbitewound)aremostcommontypespresented

DiagnosisPhysicalexaminationfindingsDiagnosticstudiesExperiencewithtraumacasesTheseshelptodeterminewhichpatientcanbemanagedconservativelyandwhichmustberapidlytakentosurgicaltherapy

DiagnosisBluntabdominaltraumacasesarechallengingdiagnosticproblemsbecausetheclinicalmanifestationsmaybedelayedforhoursorevendaysinsomecases.

DiagnosisPhysicalexaminationisthemostinformativeIncreasingabdominalsizeisanimportantclueforintra-abdominalhemorrhagePalpatetheabdomenforrigidityandpainManybluntinjuriescancauseinternalbleedingandlacerationoftheliverandspleen

ExaminationSevereVentralBruising

ExaminationPenetratingWound

ExaminationPalemucousmembranesWeakpulseProfoundhypovolemicshock

PatientTriageOftenmustbeginstabilizationtherapypriortocompletediagnosisorduringdiagnosticproceduresdependingonseverityoftheconditionIVFluidsOxygenBloodTransfusion

Diagnostic4QuadrantAbdominocentesis Fluidobtainedistestedfor: HCT,Totalsolids,CytologyBloodUreaNitrogenLipase,Amylase,andBilirubin

Diagnostic

4Quadrants

HCT

BloodUreaNitrogenRuptureoftheUrinarysystem Kidney,Ureter,Bladder

BilirubinFluidalmostblackincolor

Cytology

Radiology

RadiologyContrastmedialeakage

RadiologyAbdominalfluid=lossofdetail

UltrasoundFreefluideasytodetect.Createsaspacebetweenorgans

ManagementAbdominalcompressionbandage

TreatmentRapidvolumeexpansionIntravenousfluid(crystalloids)givenupto60-90ml/kginthefirsthourAbdominalcompressionBloodpressureevaluationFrequentgirthevaluationPCV/

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