Patient had RTA and came with abdominal tenderness and echmosis, all vitals are stable, what to do next?
Understand the Problem
The question presents a clinical scenario involving a patient who experienced a Road Traffic Accident (RTA) and presents with abdominal tenderness and echmosis (bruising). Despite these symptoms, the patient's vital signs are currently stable. The question asks what the next appropriate step in management should be, with a list of possible options.
Answer
Perform a FAST exam to evaluate for internal bleeding, followed by a CT scan if the FAST exam is positive or inconclusive.
The next step is a FAST exam. Even with stable vitals, abdominal tenderness and ecchymosis following a Road Traffic Accident (RTA) suggest possible internal bleeding or organ damage. A FAST exam is a rapid, bedside ultrasound to detect free fluid in the abdomen. If the FAST exam is positive or inconclusive, a CT scan of the abdomen should be considered to further evaluate for injuries.
Answer for screen readers
The next step is a FAST exam. Even with stable vitals, abdominal tenderness and ecchymosis following a Road Traffic Accident (RTA) suggest possible internal bleeding or organ damage. A FAST exam is a rapid, bedside ultrasound to detect free fluid in the abdomen. If the FAST exam is positive or inconclusive, a CT scan of the abdomen should be considered to further evaluate for injuries.
More Information
A FAST exam (Focused Assessment with Sonography for Trauma) is a rapid bedside ultrasound examination performed by surgeons, emergency physicians, and other trained healthcare professionals as a screening tool to look for free fluid (likely blood) in the abdominal cavity after trauma. It is non-invasive and can be quickly performed, making it a valuable tool in the initial assessment of trauma patients.
Tips
A common mistake is to assume that stable vital signs rule out significant abdominal injury. Be aware that patients can initially compensate for blood loss, and vital signs may not reflect the severity of the injury. Always consider the mechanism of injury and physical exam findings when evaluating a trauma patient.
Sources
- A patient had RTA and came with abdominal tenderness and ... - quizgecko.com
- Blunt Abdominal Trauma - StatPearls - NCBI Bookshelf - ncbi.nlm.nih.gov
- Blunt abdominal trauma in adults: Initial evaluation and management - uptodate.com
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