Trauma Guideline Manual - SUNY Upstate Medical University

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118____________ Trauma Guidelines ManualSUNY Upstate Trauma Center7. Determine maternal Rh status. If Rh negative, then administer Rhogam 300 mcg for 2ndand 3rd trimester or 50 mcg for 1st trimester.8. Obtain sonogram if ordered by obstetrician.9. In case of emergency surgery, the attending trauma surgeon may proceed with obstetricalhouse-staff while the obstetrical attending and neonatologist are responding to the hospital.10. Perimortem C-section may be undertaken by the obstetric consultant, the trauma attendingor the assigned emergency medicine physician provided:a. Signs of fetal life are presentb. Maternal demise is imminentc. Gestational age is estimated at greater than 24 weeks.11. If the gestational age is less than 20 weeks, then continuous fetal monitoring is usually notnecessary unless ordered by obstetrics.
Trauma Guideline Manual______________SUNY Upstate Trauma Center119PRACTICE GUIDELINES: EVALUATION OF HEMATURIAOBJECTIVE:Provide guidelines for the diagnosis and management of the trauma patient with hematuria.DEFINITIONS:Gross hematuria: Blood in the urine that can be seen as a change in the urine color.Microhematuria: Urine that appears normal but has tested positive for blood by either a dipsticktechnique or by microscopic examination.GUIDELINES:1. Treat the patient according to ATLS guidelines.2. Determine the presence of blood by either inserting a Foley catheter or having the patientvoid spontaneously.3. If the urine has visible cells or is red or pink, then gross hematuria is present (usually >50RBC/HPF).4. If the urine appears normal but is “dipstick positive” for blood (1+ or greater) and has RBC’son microscopic exam (usually 50 RBC/HPF, then obtain an abdominal CT scan.6. For penetrating trauma:a. If patient is unstable, go to OR for laparotomy. Obtain intraoperative IVP if necessary.This will demonstrate presence of bilateral kidneys.b. If patient is stable and has gross or microhematuria, obtain a “one-shot IVP.”
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Trauma Guideline Manual - SUNY Upstate Medical University

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