Approach to the Critical Patient

Immediate priorities

Polytrauma resuscitation framework

Pelvic hemorrhage threats

Limb-threatening branch points

Monitoring and targets

Hemodynamic monitoring bundle

Neurovascular reassessment cadence

Immediate consults

Consultation triggers

History

Mechanism and presentation

Mechanism of injury

Direction of force at impact

Symptom characterization

Pain features

Associated symptoms

Risk factors and background

Personal risk factors

Collateral and family history

Physical Exam

Vitals and general

Hemodynamic snapshot

Limb appearance

Focused hip and neurovascular exam

Palpation and motion

Neurovascular assessment

Skin and secondary survey

Soft tissue evaluation

Associated injury screen

Differential Diagnosis

Hip and pelvic fracture differentials

Bony injuries

Joint and soft tissue

Atraumatic and mimics

Pathologic and insufficiency

Non-fracture mimics

Laboratory Tests

Hematologic and transfusion

Blood count and crossmatch

Transfusion threshold

Metabolic and perfusion

Organ function panel

Targeted screening

Diagnostic Tests

Scoring Systems

Judet and Letournel classification

Roof arc and articular continuity criteria

Examination under anesthesia

MRI

MRI hip and pelvis

CT

CT pelvis without contrast

Plain radiograph adjuncts

Ultrasound

FAST and trauma ultrasound

Vascular ultrasound

Disposition

Admission and level of care

Universal admission

Specialist consultation triggers

Transfer and follow-up

Transfer criteria

Outpatient orthopedic follow-up plan

Treatment

Initial stabilization

Emergency department measures

Analgesia

VTE prophylaxis

Chemoprophylaxis options

Mechanical and monitoring

Definitive management

Nonoperative management indications

Operative management

Postoperative and adjuncts

Heterotopic ossification prophylaxis

Perioperative antibiotics

Early rehabilitation

Special Populations

Pregnancy

Pregnant trauma considerations

Geriatric

Older adult features

Pediatrics

Pediatric differences

Background

Epidemiology

Incidence and distribution

Pathophysiology

Mechanism of injury

Therapeutic Considerations

Outcome determinants

Multidisciplinary strategy

Patient Discharge Instructions

copy discharge instructions

Acetabular fracture aftercare

Warning signs to return to the ER

Recovery and prevention

References

Guidelines and key sources

Guideline and society sources

Landmark trials and evidence

Coding standards

SymptomDx is an educational tool for medical professionals. It does not replace clinical judgment. Verify all clinical data and drug dosages with authoritative sources.