2D or 3D TEEin penetrating cardiac injury No NO

[Hardcastle, Tim, Dr <tch at sun.ac.za>]

Agree

Tim
Dr T C Hardcastle
M.B.,Ch.B.(Stell); M.Med(Chir); FCS(SA)
Senior Surgeon / Senior Lecturer: Surgery (Trauma and ICU)
ATLS  instructor and DSTC Cape Town Course Director
Intern program Coordinator: Surgery
M.Med (Emergency Medicine) Executive Committee member
Clinical Head (Director): Diana Princess of Wales Trauma Unit
Division of Surgery (General) Room 4064
Department of Surgical Sciences
Tygerberg Hospital / University of Stellenbosch
PO Box 19063
Tygerberg 7505
Western Cape
South Africa
e-mail: tch at sun.ac.za
Cell: +27824681615
Office: +27219389281 or 4911 pager 0302



-----Original Message-----
From: trauma-list-bounces at trauma.org
[mailto:trauma-list-bounces at trauma.org]On Behalf Of KMATTOX at aol.com
Sent: Friday, September 07, 2007 3:47 AM
To: trauma-list at trauma.org
Subject: Re: 2D or 3D TEEin penetrating cardiac injury No NO 



 
In a message dated 9/6/2007 8:39:29 P.M. Central Daylight Time,  
rfsmithmd at comcast.net writes:

Ok so  you have an 18 yr old male presenting with a stab wound over  the
precordium. His pulse is 90, BP 110/70, RR 18. No retained missile.  Would
you do any diagnostic studies and why and what findings would you  take
action on?


Wonderful example.   As presented, there is NO WAY under God's  heaven that 
he could have a pericardial tamponade.   Too wide a pulse  pressure.    I would 
look for a pulsus  paradoxus.    I am perfectly happy with this clinical  
presentation.   I would admit him to a short term unit for overnight  
observation.  I would not object to a FAST, but even if positive I would  not operate on 
this patient who is NORMAL at this time.  
 
k



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