II. Evaluation: Bedside Monitoring
- Ventilatory rate
- Arterial Blood Gas
- Pulse Oximetry
- Capnography (EtCO2)
-
Heart Rate
- Early marker of shock (with caveat of Delayed Tachycardia in some patients)
-
Blood Pressure
- Poor measure of tissue perfusion
- Electrocardiogram
III. Labs
- Blood Type and Cross Match
- Complete Blood Count
- Chemistry Panel
-
Urine Pregnancy Test
- Indicated in all women of childbearing age
- Urine Drug Screen
- Urinalysis
- Arterial Blood Gas (or Venous Blood Gas)
- Coagulation studies (INR, PTT and Platelet Count)
- Coagulopathy is present in 30% of severely injured patients
- Indicated in known Coagulation Disorder, Massive Transfusion or serious Head Injury
IV. Imaging
- FAST Exam
- Consider Head CT
- Cervical Spine CT (typically replaces Cervical Spine XRay except in children)
- Portable AP Chest XRay (or Chest CT)
- Portable AP Pelvis XRay (or Pelvis CT)
- Consider pelvic xray in unstable blunt Trauma patients, pelvic instability, Hip Dislocation or Hypotension
- Otherwise pelvic xray is not needed if CT Pelvis will be performed (CT Pelvis has higher Fracture sensitivity)
- Soto (2015) Am J Surg 210(6): 1076-81 [PubMed]
- CT spine imaging may be reconstituted from body imaging
- CT Thoracic Spine may be reconstituted from CT chest
- CT Lumbar Spine may be reconstituted from CT Abdomen and Pelvis