Geriatric Trauma and Acute Care Surgery by Aurelio Rodriguez Robert. D Barraco & Rao R. Ivatury

Author:Aurelio Rodriguez, Robert. D Barraco & Rao R. Ivatury
Language: eng
Format: epub
Publisher: Springer International Publishing, Cham

Postoperative Care

Standard intensive care monitoring of critically ill geriatric trauma patients is described elsewhere. However, pulse and Doppler signal exams are performed hourly in conjunction with vital signs. The location and quality of the pulse (present, absent, weak) or the Doppler signal are documented by nursing and surgical team. Change in the vascular examination or signs of bleeding warrant immediate communication with the surgeon.

Mechanical thromboprophylaxis in the form of pneumatic compression devices is initiated along with subcutaneous prophylactic dosing of heparin or low-molecular-weight heparin if the risk of bleeding is sufficiently low. When a venous injury was treated with ligation, the leg should be elevated and wrapped from the toes to the groin with compression with openings to monitor the arterial pulse or the Doppler signal. Compartment syndrome should always be evaluated even if a fasciotomy has been performed.

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