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Physician / Resident Forums [ MD / DO ]
Emergency Medicine
CT or not before transfer?
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<blockquote data-quote="e30ftw" data-source="post: 15727209" data-attributes="member: 453425"><p>so you have a fairly well-appearing man with h/o abd trauma, stableish VS and a mild abd pain.. I agree with Arcan, we need more info re: mech of injury and abd exam.. any signs of trauma? can he walk? is his abd distended, ttp, etc? </p><p></p><p>I agree the pt needs CT imaging (CT thorax/abd/pelvis), however.. he's been in your ED long enough to get an abd xray read and 2 rectal exams. Couldn't you have gotten the CT by now? I moonlight in a rural ED and if anyone is sick they go straight to CT and it takes about 5 minutes since anyone else in line can just be bumped. If the guy really had a ruptured AAA he would probably be showing signs of dying by now. I assume since you got an xray, etc that he had at least an iStat hct? if his crit was stable and he looks comfortable,etc he probably doesn't have any impending traumatic abdominal catastrophe. He still definitely needs CT imaging and repeat abd exam but I'm not sure I would call for a $15k aeromedical ride just yet. Chance are if you do, he's going to end up getting discharged from the lvl 1 trauma center 200 miles from home with no ride.</p></blockquote><p></p>
[QUOTE="e30ftw, post: 15727209, member: 453425"] so you have a fairly well-appearing man with h/o abd trauma, stableish VS and a mild abd pain.. I agree with Arcan, we need more info re: mech of injury and abd exam.. any signs of trauma? can he walk? is his abd distended, ttp, etc? I agree the pt needs CT imaging (CT thorax/abd/pelvis), however.. he's been in your ED long enough to get an abd xray read and 2 rectal exams. Couldn't you have gotten the CT by now? I moonlight in a rural ED and if anyone is sick they go straight to CT and it takes about 5 minutes since anyone else in line can just be bumped. If the guy really had a ruptured AAA he would probably be showing signs of dying by now. I assume since you got an xray, etc that he had at least an iStat hct? if his crit was stable and he looks comfortable,etc he probably doesn't have any impending traumatic abdominal catastrophe. He still definitely needs CT imaging and repeat abd exam but I'm not sure I would call for a $15k aeromedical ride just yet. Chance are if you do, he's going to end up getting discharged from the lvl 1 trauma center 200 miles from home with no ride. [/QUOTE]
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Physician / Resident Forums [ MD / DO ]
Emergency Medicine
CT or not before transfer?
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