Laparotomy vs Interventional radiology Left humerus # Severe liver - - PowerPoint PPT Presentation

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Nov 09, 2022 225 likes •334 views

Extravasation right SMA Communited nasal bone # branches Laparotomy vs Interventional radiology Left humerus # Severe liver lacerations left lobe Parenchymal Haemorrhages in RUL & LUL Right L2 - L5 TP # Conservative vs operative treatment

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Right SIJ disruption Right L2-L5 TP # Parenchymal Haemorrhages in RUL & LUL

Extravasation right SMA

branches Peri-splenic haematoma

Severe liver lacerations

left lobe Left renal lacerations (grade 2/3)

Communited nasal bone #

Left humerus #

Extensive soft tissue injury

right thigh

Laparotomy vs Interventional radiology Conservative vs operative treatment Serial debridements vs watch & wait

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Stimulate Erythropoiesis Limit blood loss

Medically

Limit blood loss

Surgically

Erythropoietin Parenteral Iron Established in treatment of anaemia secondary to CKD in dialysed patients Inconclusive in anaemia following trauma Isolated case studies in Jehovah s Witnesses unclear contibution of EPO Used in chemotherapy induced anaemia often in conjunction with erythropoietins

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Stimulate Erythropoiesis Limit blood loss

Medically

Limit blood loss

Surgically

Meticulous Haemostasis Tournique t Initial Laparotomy Early amputation Use of Cell saver Cochrane review reduce relative risk by 38% 1x fasciotomy Through knee amputation Delayed surgery

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Stimulate Erythropoiesis Limit blood loss

Medically

Limit blood loss

Surgically

Limiting blood tests Limiting haemofiltration Limiting infusions Daily blood loss of 60-75 mls Accounting for 30% transfusion requirement Paediatric sampling reduces blood loss by 40%

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AKA 2nd look Laparotomy Through Knee Amputation CARDIAC ARREST

1st look Laparotomy

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