HTHSCI 2F03 Lecture Notes - Lecture 14: Spinal Anaesthesia, Spinal Canal, Hyporeflexia
26 Dec 2020
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Circulating blood volume = 7% body mass. Loss of all voluntary and reflex activity below the level of injury. Fast scan (focussed assessment c sonography in. May need swimmer"s view c abducted arm. Cartilage: iv discs should be equal height. Width of soft tissue shadow anterior to upper vertebrae should be 50% of vertebral width. Pt. doesn"t meet criteria for clinical clearance. Clear if normal radiograph and clinical exam. Ct c-spine if abnormal radiograph or clinical exam. Accumulation of >1. 5l of blood in chest cavity. Usually caused by disruption of hilar vessels. Large-bore chest drain c hep saline for autotransfusion. # of 2 adjacent ribs in 2 places. Cxr / ct chest: pulmonary contusion (white) Disruption of myocardium or great vessels blood in the pericardium filling and contraction shock. Pulsus paradoxus: sbp fall of >10mmhg on inspiration. Ecg: low voltage qrs electrical alternans. Pericardiocentesis: spinal needle in r subxiphoid space aiming at 45o towards the r tip of left scapula.
