- Insert NG to help locate esophagus
- use mets or scrape with fingers to break through fascia over aorta
- use fingers ot dissect down to spine
- if visceral/aortic penetrating injury, thoracic aorta control much better
Abdo Injury
- Zone 3 injury: explore only if intra-op explanding hematoma
- get another pair of expert hands,
Mesenteric hematoma (expanding)
- Explore take off of SMA
- Can get angio next day to look for bleeding branch and embolize (vs. exploring each branch of SMA)
Packing pelvis:
- open space of retzius and pack anteriorly
CArotid Injury:
- shunts while repairing carotid: in line shunts, baloon shunts
- Safetste ALWAYS to shunt
- if no stents available then use: IV tubing, with bevel but no point
- keep in place with umbo tape
- tie shunt in middle
Indications: to repair carotid
- <4hrs
- hemiplegic
- >4hrs intact function
- otherwisenecrotic when hook up will bleed
No comments:
Post a Comment