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Emergency Radiology - PowerPoint PPT Presentation


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Emergency Radiology. Emergency Department. clinical. Radiology. Labaratory. Patient presenting either:. Trauma. Acute diseases. At Trauma setting . Clinical. Skull base fracture . TensionPneumothorax . Flail chest . Hematuria.

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Presentation Transcript
emergency department
Emergency Department

clinical

Radiology

Labaratory

patient presenting either
Patient presenting either:

Trauma

Acute diseases

clinical
At Trauma setting Clinical

Skull base fracture

TensionPneumothorax

Flail chest

Hematuria

penetrating trauma
Penetrating Trauma

Bullets

Stab wound

Eviseration

Impalement

acute setting
Acute Setting

Tenderness at Mecburnys point

Clinical Murphys sign

Unequal pulse in aortic dissection

Crepitations in congestive heart failure

labarotry
Labarotry

In Trauma setting

1-CBC ,HB& blood typing.

2- ABG.

3-urine analysis (microhematuria)

4-Renal Functions (creatinine).

4-Liver enzymes(elevated in liver injury).

6-Pancreatic Amylase (elevated in pancreatic injury).

at the acute setting
At The Acute Setting

1-CBC(total leucocytic count).

2-ABG.

3-urine analysis(cyrstals,microhematuria&pus cells).

4-Liver Enzymes.

5-Pancreatic Amylase.

6-Blood Electrolytes.

7-ECG & Cardiac enzymes in chest pain.

in trauma setting protocol of x ray in trauma patient trauma series
In Trauma Setting(protocol of x-ray in Trauma Patient)(Trauma Series)

Cervical spine

( (AP,Lat,Openmouth)

CXR(AP)

Pelvic Xray(AP)

slide12

X-rays of the Trauma Patient

  • For the trauma patient, “x-ray everything that hurts.”The only caution is that unimportant x-rays not take precedence over treatment of life-threatening problems. For example, don’t delay operating on an epidural hematoma to take hand x-rays. If x-rays must be deferred, the reason for the delay should be written on the chart, along with a clear list of the x-rays desired. The films can be obtained later. Splint any extremity with a possible fracture if x-ray will be delayed.
  • Almost every patient with severe trauma should have a cross-table C-spine x-ray, chest x-ray, and pelvis x-ray. The rationale: Neck pain may be missed in a massively-injured patient, and the cost of missing a cervical fracture is great. The chest may have significant internal injury without external tenderness. Pelvic fractures are often present in patients with trunk trauma, and are often missed. Order these important x-rays before the patient leaves the emergency department for other care.
at the acute setting1
At The Acute Setting

CXR

Abdominal Xray (Erect,supine&lateral decubitus)

Extremity

slide17

At The Trauma setting

FAST Examination

At The Acute setting

discussed later

at the trauma setting
At the trauma setting

Brain

chest

Abd&pelvis

bones

Orbit

at the acute setting2
At The Acute Setting

CT brain in Hge or infarction or tumors

CT orbit in ophalmitis

CT CHEST (e.g. dissection)

Abd&pelvis

1 trauma
1-TRAUMA

Blunt Trauma

Penetrating Trauma

blunt trauma causes
BLUNT TRAUMA (Causes)

MVA

Fall from height

Fight

mechanism of injury
Mechanism of Injury

Compression

Crushing

Shearing

(Acceleration/Deceleration)

penetrating injuries
Penetrating Injuries

Stab

Gun shot injury

mechanism of injury1
Mechanism of injury

Low-velocity projectiles

  • A knife or projectile, for example, produces tissue damage by stretching and crushing; injury is usually confined to tissues in the path of penetration
  • The severity of the internal injury depends on the organ penetrated and on how vital the organ is.

High Velocity Projectiles

  • GSI leads to injury along its path + by shock waves to the adjacent structures.

(so it’s more dangerous)

  • The degree of injury also depends on the biomechanics of the penetrating projectile .
  • velocity, size of impact face, and deformability, and the density of the body tissues penetrated