"44 yrs old unrestrined driver sustain accide - tibebe

[ArchivalUser]

a vehicle one .his BP @ the time of the scene was 70/30mmHg & aft. receiving 2 units of bld
raised to 80/40mmHg.his abd . slightly distended ,-ve intrapertoneal lavage for bld & also no organ damage seen on abd. U/S. his neck veins 're not distended,lung is clear .imaging studies indicate pelvic bone & rt. 4th rib fructure.what 'll be the next best mx?
a.abd.CT scan
b.pericardicenthesis
c.chest tube
d.laparatomy
e.angiogram

[ArchivalUser]

Dd

[ArchivalUser]

_ DDD

[ArchivalUser]

please explain.

[ArchivalUser]

E..

[ArchivalUser]

eeeeeeeeee

[ArchivalUser]

the ans=e.
b/c diagnostic intraperitoneal lavage & abd.u/s=r/o intraperitoneal bleeding so the next
step is to assess the retroperitoneal bleeding 2 to the pelvic # as the cause of the hemodynamic instability despite resucitation=pelvic angioram helps as a diagnostic and
therapeutic measure thru embolising the bleeding vessel.