Orthopedics focuses on the musculoskeletal system. Learn about the diagnosis, treatment, and rehabilitation of bone, joint, ligament, and muscle conditions.
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One of the most critical tools in the trauma bay is the ultrasound machine. The FAST exam (Focused Assessment with Sonography in Trauma) is a rapid bedside ultrasound.
The doctor places the probe on four spots of the belly. The probe is placed on the areola, which is located on the chest. They are looking for black fluid—blood—pooling around the liver, spleen, or heart. If they see blood in an unstable patient, it is an immediate ticket to the operating room. There is no time for a CT scan. The FAST exam saves lives by identifying internal bleeding in seconds without radiation.
Mobility is central to quality of life. Orthopedic conditions are the leading cause of disability worldwide. They can range from acute, short-term injuries like a sprained ankle to chronic, progressive diseases like osteoarthritis. The goal of orthopedic care is not just to fix a broken part, but to restore function, alleviate pain, and help patients return to their daily activities, whether that involves high-performance sports or simply walking without pain.
If the patient is stable enough (meaning their blood pressure is holding steady), they are taken to the CT scanner. Computed Tomography (CT) is the workhorse of trauma diagnosis. It provides detailed, 3D images of the head, neck, chest, abdomen, and pelvis.
This is often called a “pan-scan” or “head-to-toe” scan. It reveals brain bleeds, fractures of the spine, tears in the aorta, and lacerations of the liver or spleen. It can see injuries that are impossible to find with a physical exam. The speed of modern scanners means a full body scan can be done in minutes.
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While CT is more detailed, plain X-rays still have a role. A chest X-ray is often taken immediately in the trauma bay to check for a collapsed lung or widened heart shadow. A pelvic X-ray is also standard to check for fractures of the pelvic ring, which can cause massive, hidden bleeding.
Limb X-rays are taken to diagnose broken arms and legs. Although painful, these fractures are usually not immediately fatal, so they are often imaged after the life-threatening chest and belly issues are ruled out.
Simultaneously, nurses draw blood for rapid analysis. A “type and cross” is the most important test—it determines the patient’s blood type so that compatible blood can be given for transfusion.
Other tests check lactate levels (a sign of shock), hemoglobin (blood count), and coagulation profile (how well the blood is clotting). In trauma, blood often loses its ability to clot, a condition called coagulopathy. Monitoring this allows doctors to give specific blood products like plasma and platelets to fix the clotting system.
Accurate diagnosis in orthopedics relies on a combination of clinical skills and advanced technology. The goal is to not only identify what is wrong but also to quantify the severity, often referred to as grading or staging, to determine the most appropriate treatment pathway. At Liv Hospital, we utilize a comprehensive diagnostic approach to ensure no detail is overlooked.
This is an older technique, now largely replaced by the FAST exam and CT, but still used in specific situations. If a patient is too unstable for a CT and the ultrasound is unclear, a doctor might make a small cut below the belly button and insert a catheter.
They wash the belly with saline fluid and then drain it back out. If the fluid comes out bloody, it confirms internal bleeding, and the patient goes straight to surgery. It is invasive but definitive.
If a CT scan shows bleeding from a specific vessel (like in the pelvis or spleen) but the patient is relatively stable, they might go to interventional radiology instead of the operating room.
Here, an angiogram is performed. A catheter is threaded through the arteries to the bleeding point. The doctor can then inject coils or glue to plug the vessel from the inside. This minimally invasive technique can stop bleeding without the need for open surgery.
No. It is just an ultrasound probe with gel on the skin. It is painless and noninvasive.
Doctors need to see the entire body immediately to check for hidden wounds, like a stab wound to the back or an open fracture. Undressing a patient in pain takes too long and requires moving them, which could be dangerous if the spine is unstable.
A full-body CT scan involves a significant dose of radiation. However, in a trauma setting, the risk of missing a lethal injury far outweighs the long-term risk of radiation. Doctors use it judiciously but prioritize immediate survival.
Usually, only your tissue is used for the eardrum. If the hearing bones need repair, a tiny titanium or plastic part might be used, but you cannot feel it.
Surgeons use a speculum or retractors to hold the ear canal open and steady, allowing them to work with both hands under the microscope.
Under the doctrine of “implied consent,” doctors will perform all necessary life-saving procedures, scans, and surgeries if you are unable to speak for yourself in an emergency.
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