Who is in charge of my pt - page 3
Long story-short had a through and through gunshot tonight that went through left leg and then through the penis ER doctor said not to cath the pt, and then a little later the trauma surgeon who... Read More
Aug 27, '08I guess the point on which I'm stuck is ... for what period of time was it "unknown" whether or not the urethra was transected?
With an obvious soft tissue injury to the groin, I can understand not inserting the foley immediately on the patient's arrival in the ER ... but foley insertion is generally not a task completed in the first 10 minutes of a trauma anyway. After CT/x-ray/other imaging ... then the extent of injuries is known and other treatment proceeds.
Aug 28, '08It was about 3 hours or a little more that we did not know how much damage there was to the penis. Pt came in about 930 or 10pm and we didn't know until the urologist came at about 0130 and completely checked the guy out.
By the way the kid has gone home and is rumored to be doing fine.
Aug 28, '08
Aug 28, '08Quote from AltraI suppose I didn't clarify our "don't cath a pelvic fx" practice. I didn't mean that we don't cath any pelvic fx patient. If there is a pelvic fracture we watch for evidence of a urethral/bladder injury. Especially if it is an unstable pelvis. Once cleared by CT, by all means cath.But this don't-catheterize-a-pelvic-fx is just not typical practice. Do you propose repeatedly positioning & repositioning that fractured pelvis on a bedpan?? I didn't think so.