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Published byCurtis Hancock Modified over 9 years ago
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ESTABILISHED STANDARD PREHOSPITAL TRANSPORT PROTOCOL AND EMERGENCY DEPARTMENT MANAGEMENT ALGORITHMS 11% PREALGORITHM 7% POST ALGORITHM
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1-MOTORCYCLE COLLISION 2-CAR VS PEDESTRIAN 3-FALL OVER 4.6 M 4-LATERAL IMPACT 5-MVC WITH VEHICLE INCOMPATIBILITY HIGH ENERGY TRAUMA
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MEN > WOMEN 33YEARS
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SUSPICION OF PELVIC FRACTURE 1-MECHANISM OF FRACTURE EMERGENCY MEDICAL PROFESSTIONAL INFORMATION 2-PATIONT PRESENTATION 3-PHYSICAL EXAM
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1- SHORTENING OF LOWER LIMB VERTICAL SHEAR 2-LATERAL ROTATION ROTATIONAL INSTABILITY 3-PRINEAL ECHYMOSIS AND FLANK SCROTAL,LABIAL 4-RECTAL BLEEDING 5-VAGINAL BLEEDING URETHRAL BLEEDING -6
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PHYSICAL EXAM 1-LATERAL COMPRETION (ILIAC WING) 2-ANTEROPOSTERIOR COMPRETION MAKE PAIN OR GROSS INSTABILITY 3-GAP OR PUBIS SYMPHYSIS SEPARATION 4-VAGINAL AND RECTAL EXAM HIGH POSISION PROSTAT=URETRA TEAR RECTAL EXAM IN CHILD ONLY WHEN HEMORAGE
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5-NEROLOGIC EXAM SCIATIC NERVE AND LUMBOSACRAL BRANCHS IS NEAR Fx BULBOCAVVERNUS REFLEX MOTOR FUNCTION
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IMAGING 1-STANDARD AP COLINEAR PUBIS SYMPHYSIS AND SACRAL SPINOUS PROCESS 1-DISPLASMENT OF SACRUM OR SI JOINT 2-L5 SPINOUS PROCESS FRACTURE 3-PUBIS SYMPHYSIS DIASTASIS OR RAMI Fx WITH DISPLACEd
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PELVIC INLET PROJECTION 45 DEGREE CODAL 1-LATERAL ROTATION OF HEMIPELVIC 2-OPEN SI JOINT 3-IMPACT SACRAL ALA 4- AP DISPLACEMENT OF HEMIPELVIC
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PELVIC OUTLET PROJECTION 45 DEGREE CEPHALAD 1- SACRUM 2-SI JOINT 3-VERTCAL DISPLACEMENT 4- UNSTABLE HEMIPELVIS
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FLEXION EXTENTION DEFORMITY IS SEEN IN 3 XRAY BUT IS BETTER OUT LET VIEW( ROTATION POINT IS TYPICALY AT POSTERIOR RING)
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CT SCAN 2-3 mm AXIAL SECTION IS GOOD FOR MAJORITY OF SIGNIFICANT INJURIES GOOD FOR THREE DIMENTIONAL RECONSTRACTIONS
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CT IS INDICATED DOUBT ABOUT THE DIAGNOSIS IN PLAIN RADIOGHRAPH OPERATIVE INTERVENTION IS PLANNED
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CT SCANNING CHANGED INJUREY CLASSIFICATION IN 15% MANAGEMENT IN 3% OF PATIENTS
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CT AIDS DECISION FOR OPERATION AND CONSERVATIVE IMPROVE OPERATION APPROACH SELECTION
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MANY TRAUMA CENTERS OPTAIN CT ROUTINLY FOR ABDOMEN AND PELVIC VISCERAL INJURY
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MRI OFFERS SIMILAR BENEFITES OF CT,WITH THE ADVANTAGES OVER CT IN DELINEATING SOFT TISSUE INJURIES,ABSENCE OF IONIZING RADIATION,FRACTURES OF CARTILAGINOUS STRACTURES
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RADIOISOTOPE BONE SCAN IS RARELY USEFUL FOR THE DIGNOSIS OF NONDISPLACED PELVIC FRACTURES AND IN THE IDENTIFICATION OF ACUTE INJURIES IN CHILDREN ADULTS WITH HEAD INJURIES OR MULTIPLE SYSTEM INJURIES
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Unstable pelvic fractures 1-2.5 cm pubis symphysis disruption 2-sacro spinous lig rapture 3-lateral sacral avulsion fx 4- ischial spine fx 5-sachral fx with gap(vertical Instability )
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6-L5 TRANSVERS PROCESS FX (VERTICAL INSTABILITY ) 7-VERTICAL DISPLACEMENT OF HEMIPELVIS 1CM (VERTICAL) 8-STRES TESTING FOR INSTABILITY ONLY ONE TIME HEMODINAMIC INSTABILITY AND ZONE 2,3 SACRUM DUE TO NERVE INJURY
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STABLE Fx 1- intact posterior ligament 2-impact fx of anterior sacrum In LC fractures) )
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