Fractures
Blood everywhere
Gun Shot Wounds
Limb pain
Everything else
100
The three examination to look for
What is
1. neurovascular status
2 sign of compartment syndrome (high velocity)
3 associated wounds (tissue and bone damage extent)
100
The concerning compartment pressures and Delta P for fasciotomy
What is 30 mmHg and <30 mmHg (<20 is definitive)
200
Associated injuries with shot in the hip (decrease order)
Bowel perforation>Vascular Injury>urogenital injuries
200
The norma compartment pressure (adult and kids)
what is adult 8-10mmHg and children 10-15mmHg
300
The most important action and 2 complications
What is Surgery to remove bullet to avoid lead intoxication and joint destruction
300
The compartments most at risk of acute compartment syndrome (state 2)
What is anterior compartment
LE- thigh anterior
foot - interosseous intracompartment,hindfoot, calcaneal
UE- volar forearm
400
Three categories of gun shot wounds
What are
1 low velocity (350m/s or 1200 feet/s)
2. Intermediate velocity (350-650 m/s or 1200-2000 ft/s)
3 High Velocity (>600 m/s or >2000 feet/s)
400
The method for compartment pressure measurement
What is catheter within 5cm of fracture (tip outside actual fracture) with transduce at level of measured compartment
500
The Gustilo classification
what is
- Type I
- wound ≤1 cm, minimal contamination or muscle damage
- Type II
- wound 1-10 cm, moderate soft tissue injury
- Type IIIA
- wound usually >10 cm, high energy, extensive soft-tissue damage, contaminated
- adequate tissue for flap coverage
- farm injuries are automatically at least Gustillo IIIA
- Type IIIB
- extensive periosteal stripping, wound requires soft tissue coverage (rotational or free flap)
- Type IIIC
- vascular injury requiring vascular repair, regardless of degree of soft tissue injury
Intra op examination best to grade fracture
https://www.orthobullets.com/trauma/1003/gustilo-classification
500
Fasciotomy Indications (state 3)
What is
Clinical signs/symptoms suggestive ACS
Intracompartment pressure >30mmHG or Delta P <20
Inctacompartment pressure >20 mmHg WITH hypotension
Interruption in arterial perfusion for >4 hours