Home // About Us // Privacy Statement // Sponsorship Policy // Contact Us

Case 82: "I think I've been stabbed"

A 22 year old man is brought to the emergency department with a wound in the left flank. He is pale, shivering, and peripherally shutdown.

1. What is your first priority?

The airway. Remember this is a trauma patient and his management is dictated by trauma principles.

2. What would be your immediate management?

Alerting and assembling the trauma team. A leader should be quickly decided upon and each person's responsibilities delegated. The radiology department should be alerted and theatre should be standing by.

Then for the assessment as the patient is wheeled in.

Primary survey. At the same time instituting resuscitation and monitoring. Immediately life threatening injuries are sought in a systematic manner and appropriate emergency manoeuvres instituted. For instance, in this patient especially, tension pneumothorax and cardiac tamponade should be considerations. A secondary survey follows with definitive care.

3. Which organs are at risk of injury with this wound?

It is often easy to think of possible injuries per body cavity. However, there could be multiple injuries and injuries in multiple body cavities.

Intraabdominal: spleen, stomach, splenic flexure colon, kidney, pancreas, aorta, IVC, liver.
Thoracic: Lung, cardiac, oesophagus, aorta.

Mr Patrick Moore - General and Bariatric Surgeon.