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A 45 yr old male with cold, pale, painless, pulseless extremity with blocked blood supply is in the field. Its been 7 hrs, what should be the next step?
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| galadusmle
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angiography anyway
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| no more a loser
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catheterization n fasciotomy as he is at risk for compartment syndrome
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| incre_hulk
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Doing a doppler first would probably locate the lesion and determine the gradient.....
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| zaki
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if no compartment syndrome then angiography and bypass surgery or angioplasty
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| cool
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| | 07/23/04 - 01:17 AM
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| #6 |
i think first we will do doppler , then further steps , like fasciotomyand bypass
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| asmi
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don't you think duration is imp..7 hrs....so we have to be prompt in treating him...faciotomy.
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| dmnz
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ASMI-What will you do about embolus sitting in leg?
I think the order shall be = cath --> cure(embolectomy/bypass)-->cut fascia(fasciotomy)
Cure and cut simultaneously in same setting.
dmnz :wink:
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| mdwannabe
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in the field???? what do you mean???? what are options available to physiscian? Does she carry a TPA bolus with her? Coz tha would would still be an option. Dopler??? Instruments??? Please be a little more specific.
How do you perform embolectomy in the field? Fasciotomy is a possiblilty...but what i the history??? Coz that would indicate possibility of Compartment Syn...
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| no more a loser
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the pt is in the field (meaning away from the hosp) so u would do catheterization and fasciotomy.
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| mdwannabe
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and may I ask what would you cath this person with??? I agree with fasciotomy... but cath..in the field???
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