Evaluation and Management of the Trauma Patient for the Interventional Radiologist

 

 Buy Article Permissions and Reprints

ABSTRACT

Interventional radiologists are adopting an increasingly important role in the evaluation and management of the acutely injured patient. The interventional radiologist may be called upon to provide services while hemorrhage is active, the patient is hemodynamically compromised, and a comprehensive trauma assessment is incomplete. The initial diagnostic and management approach to the trauma patient is optimally organized through the principles of advanced trauma life support. A basic understanding of common injury patterns, immediate lifesaving interventions, and principles of resuscitation is of value to the interventional radiologist in his or her interactions with the trauma team and contribution to patient care.

REFERENCES

• 1 American College of Surgeons .Advanced Trauma Life Support Student Manual, 8th ed. Chicago, IL;
  PubMedGoogle Scholar
• 2 Zengerink I, Brink P R, Laupland K B, Raber E L, Zygun D, Kortbeek J B. Needle thoracostomy in the treatment of a tension pneumothorax in trauma patients: what size needle?.  J Trauma. 2008;  64 111-114
  CrossrefPubMedGoogle Scholar
• 3 Beekley A C, Sebesta J A, Blackbourne L H 31st Combat Support Hospital Research Group et al. Prehospital tourniquet use in Operation Iraqi Freedom: effect on hemorrhage control and outcomes.  J Trauma. 2008;  64(2 Suppl) S28-S37 discussion S37
  CrossrefPubMedGoogle Scholar
• 4 Kragh Jr J F, Walters T J, Baer D G et al.. Practical use of emergency tourniquets to stop bleeding in major limb trauma.  J Trauma. 2008;  64(2 Suppl) S38-S49 discussion S49-S50
  CrossrefPubMedGoogle Scholar
• 5 Kragh Jr J F, Walters T J, Baer D G et al.. Survival with emergency tourniquet use to stop bleeding in major limb trauma.  Ann Surg. 2009;  249 1-7
  CrossrefPubMedGoogle Scholar
• 6 Roberts I, Alderson P, Bunn F, Chinnock P, Ker K, Schierhout G. Colloids versus crystalloids for fluid resuscitation in critically ill patients.  Cochrane Database Syst Rev. 2004;  (4) CD000567
  PubMedGoogle Scholar
• 7 Bulger E M, Jurkovich G J, Nathens A B et al.. Hypertonic resuscitation of hypovolemic shock after blunt trauma: a randomized controlled trial.  Arch Surg. 2008;  143 139-148 discussion 149
  CrossrefPubMedGoogle Scholar
• 8 Stern S A, Dronen S C, Birrer P, Wang X. Effect of blood pressure on hemorrhage volume and survival in a near-fatal hemorrhage model incorporating a vascular injury.  Ann Emerg Med. 1993;  22 155-163
  CrossrefPubMedGoogle Scholar
• 9 Sperry J L, Ochoa J B, Gunn S R Inflammation the Host Response to Injury Investigators et al. An FFP:PRBC transfusion ratio >/=1:1.5 is associated with a lower risk of mortality after massive transfusion.  J Trauma. 2008;  65 986-993
  CrossrefPubMedGoogle Scholar
• 10 Gunter Jr O L, Au B K, Isbell J M, Mowery N T, Young P P, Cotton B A. Optimizing outcomes in damage control resuscitation: identifying blood product ratios associated with improved survival.  J Trauma. 2008;  65 527-534
  CrossrefPubMedGoogle Scholar
• 11 Borgman M A, Spinella P C, Perkins J G et al.. The ratio of blood products transfused affects mortality in patients receiving massive transfusions at a combat support hospital.  J Trauma. 2007;  63 805-813
  CrossrefPubMedGoogle Scholar
• 12 Cotton B A, Gunter O L, Isbell J et al.. Damage control hematology: the impact of a trauma exsanguination protocol on survival and blood product utilization.  J Trauma. 2008;  64 1177-1182 discussion 1182-1183
  CrossrefPubMedGoogle Scholar

Steven L GlorskyM.D. F.A.C.S. 

Department of Surgery, ATTN:MCHE-SDG, 3851 Roger Brooke Drive

Fort Sam Houston, TX 78234-6200

Email: steven.l.glorsky@us.army.mil