Initial investigations that are essential in the multitrauma patient
- X match
- CXR (supine)
- Lateral Cervical spine Xray indicated if:
Head Injury
Severe faciomaxillary injury
Mechanism of injury eg. sudden deceleration
Cervical spine pain /tenderness
Signs of spinal cord injury
Cervical spine X-ray checklist need to see from C1 to C7/T1 interspace
- Alignment of the anterior & posterior vertebral lines,
the spino-laminar line and tips of spinous processes
- Bones compression of vertebral bodies, C1 peg
- Cartilage disc spaces should be equal
- Soft tissue prevertebral space
Chest X-ray - checklist
- Lungs look for evidence of aspiration, contusion
- Pleura look for haemopneumothorax
- Heart shadow if enlarged suspect pericardial tamponade
- Pneumomediastinum / pneumopericardium / subcutaneous emphysema suspect major
airway injury
- Ribs if upper ribs fractured then patient at high risk of major intrathoracic
trauma
St. Vincent's Hospital Melbourne. Department of Anaesthesia. ©2003