Management of solid organ trauma

Author(s): Leyla Mohamed, Dr Deborah Low

Hospital: Barts Health NHS Trust

Reference: RAD Magazine, 47, 557, 13-14

Excerpt: 

In the last two decades, management of blunt and penetrating solid organ trauma has seen a major transition from operative management (OM) or damage control surgery (DCS) to non-operative management (NOM), guided principally by the haemodynamic stability of the patient. This shift is predominantly due to better knowledge of the natural history of solid organ trauma, advances in imaging and increased availability of less invasive techniques.

The Advanced Trauma Life Support (ATLS) programme highlights several clinical and biochemical parameters to aid in the prompt recognition of the haemodynamic state of the patient following trauma,4 which in turn guides the management of patients either through DCS or NOM. Haemodynamic instability is defined as a systolic BP <90mmHg, heart rate of >120, cold and clammy, altered consciousness and breathlessness. Unstable patients are more likely to be managed with DCS.

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