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PubMed1977

Peritoneal lavage.

The concept of lavage as an effective means for detecting intraperitoneal injury secondary to trauma has been adequately demonstrated. The value of peritoneal lavage is especially reflected in the statistics reporting approximately 20 per cent incidence of unnecessary celiotomies when physical examination findings alone are used; whereas the number of false-positives and false-negatives may be lowered significantly. Not only does peritoneal lavage decrease the number of unnecessary celiotomies, but it also provides for a more rapid diagnosis that can prevent greater blood loss, thereby reducing the number of subsequent transfusions, minimizing chances of hepatitis, and lowering the incidence of shock with its coincident complications.

Abdominal Injuries↗

PubMed1977

Selective use of radiography of the skull and cervical spine.

Based on the findings of a five-month study, the authors suggest that physicians should be more discriminating in using radiography of the skull, especially when dealing with patients who are minimally injured. The low incidence of fractures disclosed by radiography in patients with insignificant head injuries is a primary factor in arriving at this recommendation. A lack of correlation between skull fractures, and cerebral injury, and subsequent therapy is another factor. Finally, the prohibitive cost of medical care generally (and radiographs in particular) makes greater selectiveness imperative. Although the number of cervical spine fractures in this study was small, the findings indicate that based on history and physical examination there can and should be increasing selectivity in ordering routine cervical spine series, without increasing the risk of missed fractures.

Cervical Vertebrae↗