A patient had RTA and came with abdominal tenderness and ecchymosis, all vitals are stable, what to do next?
Understand the Problem
The question describes a patient who has been in a motor vehicle accident (RTA) and presents with abdominal tenderness and ecchymosis, but has stable vital signs. It asks what the next step in management should be, with the options being FAST (Focused Assessment with Sonography for Trauma) exam, CT scan, DPL (Diagnostic Peritoneal Lavage), or laparotomy.
Answer
The next step is a CT scan of the abdomen and pelvis to investigate internal injuries, despite stable vitals.
Given the patient's RTA (likely Road Traffic Accident), abdominal tenderness, and ecchymosis, the next step, even with stable vitals, should be a thorough investigation for internal injuries. CT scan of abdomen and pelvis is very helpful.
Answer for screen readers
Given the patient's RTA (likely Road Traffic Accident), abdominal tenderness, and ecchymosis, the next step, even with stable vitals, should be a thorough investigation for internal injuries. CT scan of abdomen and pelvis is very helpful.
More Information
Ecchymosis and abdominal tenderness following trauma are signs of possible internal bleeding or organ damage, even if vital signs are initially stable. Delayed bleeding or other complications can occur.
Tips
A common mistake is to be falsely reassured by stable vital signs. Internal injuries can be present even with stable vitals and can deteriorate rapidly.
Sources
- Blunt Abdominal Trauma - StatPearls - NCBI Bookshelf - ncbi.nlm.nih.gov
- Trauma Secondary Survey - StatPearls - NCBI Bookshelf - ncbi.nlm.nih.gov
- CT in Abdominal Trauma - The Radiology Assistant - radiologyassistant.nl
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