-- [ From: Martin Herman * EMC.Ver #2.5.3 ] --
I actually think the pediatrician in this case did a reasonable job..
Now I would have gotten CSPINE films or documented a normal exam ( no
step off, bogginess r tenderness ) if the patient were mentating
normally.. I also might have done a CXR( looking for pulmonary
contusion, pneumothorax or broken ribs since he reportedly feel from the
height of the basketball rim( 10 feet isn't it?)
As for other evaluation ,, examinations done serially should have been
I wonder about the value of giving mannitol to a patient that was
basically stable , even though the one pupil was dilated there was no
hypertension, bradycardia or hypopnea was there? SO does shrinking the
brain and possibly allowing for even more expansion of the hematoma make
sense? Especially since he was going to the OR soon anyway? Don't the
hematomas tamponade themselves? I usually reserve the mannitol for those
who are deteriorating and will be taken to the OR post haste..
Hope you this is what you meant by considered thoughts..
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