Urologic trauma – ETM Course

In this episode we talk to Joseph Mathew, one of the authors of a great new article on a novel technique for tamponade of bleeding related to pelvic fractures.

Joseph is a Consultant Emergency Physician with the inpatient Trauma Service and Emergency Department at the Alfred in Melbourne, and is also head of International Programs (South Asia) with the National Trauma Research Institute.

In this episode we talk with him about the rationale for delaying bladder catheterisation until after CT in blunt abdomino-pelvic trauma, and the novel concept of bladder inflation with saline to assist with tamponade of haemodynamically unstable pelvic fractures. We also cover the oft-misunderstood procedure of retrograde urethrogram (RUG).

This is a great locally written article and I’d recommend you check it out!

Delaying urinary catheter insertion in the reception and resuscitation of blunt multitrauma and using a full bladder to tamponade pelvic bleeding. Huang S, Vohora A, Russ M, Mathew J, Johnny C, Stevens J, Fitzgerald M. Injury. 2015 Jun;46(6):1081-3

Click on the image to go to the abstract at Injury

This is the other article Joseph refers to by Carl Luckhoff et al – a retrospective review showing that only 2-3% of 998 patients with pelvic fractures had urethral injury, and the combination of classic clinical signs and pubic symphisis disruption had 100% sensitivity for urethral trauma.

The diagnosis of acute urethral trauma. Lückhoff C, Mitra B, Cameron P, Fitzgerald M, Royce P. Injury 2011 Sep;42(9):913-6