This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Little, G. Articles by Glucksman, E Search for Related Content Social Bookmarking                   What's this?

Critical pitfalls in the immediate assessment of the trauma patient

Accident and Emergency Department, King’s College Hospital, London, UK, George.Little{at}kingshc.nhs.uk

Michael Kelly

Accident and Emergency Department, King’s College Hospital, London, UK

E Glucksman

Accident and Emergency Department, King’s College Hospital, London, UK

In the immediate assessment of trauma patients, critical pitfalls exist that may interfere with optimal clinical care. Failure to recognize the need for early anaesthesia and endotracheal intubation may put the patient at unnecessary risk and delay the assessment and treatment process. Pressure to clear the cervical spine may lead to inadequate imaging and premature removal of neck immobilization devices. The limitations of the initial chest X-ray in diagnosing pneumothoraces may not be appreciated and needle thoracentesis may be ineffective. ‘Springing’ the pelvis to assess for instability may cause life-threatening haemorrhage and should not be done prior to the initial pelvic X-ray. Log rolling may dislodge crucial clot formation and promote bleeding, and should only be used for diagnostic purposes. Applying clinical common sense to the assessment of trauma patients may avoid the pitfalls whilst allowing the clinician to operate within internationally agreed assessment and treatment frameworks.

Key Words: Trauma • rapid sequence induction • emergency intubation • cervical spine • pneumothorax • computed tomography • pelvic fracture • log roll

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?