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Originally Posted by wook

Vascular injury would be a concern, as would urethral tear. At some point early on I would do a RUG (Retrograde UrethroGram). If tear and no urologist to place the foley, probably try gentle placement of a foley (debate recently in literature about this). Obtain pelvic xray. I would probably also obtain CT pelvis (IV contrast). Also, concern for testicular injury...this can be evaluated by urologist ASAP (ie transfer). Get the rainbow (CBC, BMP, PT/PTT/INR, T&S). Also, a rectal exam would be helpful to see if gross blood (concern for injury of the GI tract/colon). Two large bore IV, O2, monitor.

Regarding amputation, advise him further studies are needed to fully evaluate the extent of the injury.


Wook

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