39 yr male RTA GCS 15/15 No co morbidity No LOC/ ENT BLEED /SEIZURES FURTHER MANAGEMENT??


Although GCS 15/15 and no ENT bleed go for NCCT head and neurosurgical clearance, than thorough cleaning of all wounds with NS and betadiene lotion followed by repair in layers and splintage in functional position for hands and take a orthopedic opinion... Thank you Dr. Neeraj Mangla Dr. Neeraj Mangla
Ct showed contusion over temporal region Rest spine is normal .

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Once all acute management is over and he is stable. Please take a Scaphoid series XRay and proceed for the suspected scaphoid fracture
Scaphoid fracture in the first xray,lacerated wound in the forehead require thorough debridement and cleansing with sterile ns and betadine and suturing the wound,tetanus prophylaxis- tetanus immuno globulin along with toxoid,observation for any neurological deterioration, loc, vomiting,giddiness, ent, nose bleed
Cleaning and suturing the wounds, antibiotics, analgesics, observe for 72 hours for signs of cerebral concussion, contusion and haemorrhage. Wait and watch.
primary management and suturing of qounds. pls get a CTwrist. looks like a displaced scaphoid fracture.
This is fracture scaphoid distal end. Chances of AVN are less. Apply scaphoid cast ...
Looks severe, get CT head plain to rule out bleeding inside skull
Small contusion

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Agree with Dr. Ravi sir
In TT , Inj Vivaran , PPI ,antiemetics , IVF , Suturing of lacerations under local anaesthesia, properly exam the patient fir other injuries , including chest , and abdomen , and rule out hypotension, CT HEAD, CXR, USG Whole abd. , admit under neurosurgeon for Observation .after ruling out abdominal and chest Trauma.
Left fronto temporal lacertion...CT brain.look for bone /intracranial injury if any...Rx primary suturing ,antibiotics, antiinflammatory,.... Look for tendon injury in knee if yes bunnel suturing with pop or simple primary suturing. Look for sch if any.
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