Trauma Guideline Manual - SUNY Upstate Medical University
Trauma Guideline Manual - SUNY Upstate Medical University
Trauma Guideline Manual - SUNY Upstate Medical University
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60____________ <strong>Trauma</strong> <strong>Guideline</strong> <strong>Manual</strong><strong>Upstate</strong> Medial <strong>University</strong> <strong>Trauma</strong> Centerplaced on diagnosis as well as those patient undergoing general anesthesia (i.e.for a femur fracture.)iv. Occult pneumothorax seen on CT scan without plain film findings can be treatedwithout chest tube. If the patient goes to operating room, is intubated or istransferred by air ambulance, then a chest tube or close interval follow-up shouldbe considered.l. Fractured ribs:i. Physiology: ribs fracture from direct force or from massive AP force.ii.Diagnosis:a) Chest wall pain.b) Bony crepitus.c) Fractured ribs on chest X-ray.d) Remember that the anterior costochondral cartilages can be fractured and notshow up on chest X-ray.iii. Treatment:a) Pain control: epidural, PCA, morphine drip.b) Pulmonary toilet.c) Drain intrapleural fluid accumulation.