AAAAA
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30 M presents with fall. Has bruise over L side of abdomen. In C-spine collar. Vitals stable. Manage for 1o or 2o survey. DPL shows free fluid in abdomen. Likely splenic rupture. Acute management. SURGERY
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| AAAAA
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Professionals begin performing a primary survey, consisting of assessment of airway, breathing, and circulation (called the "ABC's"). The purpose of the primary survey is to identify life-threatening problems. Ensuring that the injured person is not disabled by unnecessary movement of the spine is paramount, so the neck and back are secured before moving the patient. Unless the victim is in imminent danger of death, first responders will usually "load and go" transporting the victim immediately to the nearest appropriate trauma-equipped hospital.
Upon completion of the primary survey, the secondary survey is begun. This may occur during transport or upon arrival at the hospital. The secondary survey consists of a systematic assessment of the abdominal, pelvic and thoracic viscera, complete inspection of the body surface to find all injuries, and neurological exam. The purpose of the secondary survey is to identify all injuries so that they may be treated. A missed injury is one which is not found during the initial assessment (for example, as a patient is brought into a hospital's Emergency Department), but rather manifests itself at a later point in time, sometimes with baleful consequences (i.e., a liver laceration is sometimes missed and a patient sent home, who will abruptly go into shock shortly thereafter.)
The appropriate first aid for a trauma patient is to immediately call for help using the emergency medical service, then treat for shock. Do not move the victim unless failure to do so would create a greater risk to their life (i.e. hazardous chemicals or a spreading fire). Also see wilderness first aid if immediate emergency help is unavailable.
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| Cedrick
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Thank you Doctor
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| Cedrick
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The more I re read this one,is good
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| waqastariq
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I dont get it..whats its use in CSA?
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| AAAAA
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They always ask this in CSA !!
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seeking study partner in USMLE, Canadian MCC OSCE examination
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| AAAAA
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Topics: 156
Posts: 1,991
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DPL shows free fluid in abdomen. Likely splenic rupture. Acute management. SURGERY
The answer is not surgery. Wrong.
The USMLE Part 2 CS ask you to start 2 large bore IV 16 gauge, type and cross 2-4 units of pRBC, and transfuse, get CBC, lytes, PT, PTT, liver function test and also coag and DIC.
they ask you how to manage a surgical patient in the emergency room. You need to know the blood type and keep the B/P above 90 and Oxygen 100% non-rebreathing mask and EKG monitor.
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| AAAAA
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DPL represents diagnostic peritoneal lavage which indicates bleeding from the internal organs and spleen is the organ which is ruptured.
Need ABC primary and secondary survery in USMLE Part 2 CS
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