Special Considerations

RAPID DECELERATION FORCES Rapid deceleration injuries may result in renal pedicle and vascular injuries. Such injuries result in high mortality rates, but fortunately they are quite rare, occurring in less than 1 percent of blunt renal trauma. However, hematuria, the clue to renal injury, may not be present. Accordingly, patients whose mechanism of injury is from forces of rapid deceleration should have a renovascular imaging study. Since pedicle injuries virtually always occur in association with other significant injuries,5 other indications for radiographic evaluation are likely. Many such patients have other indications for surgical exploration.

PEDIATRIC BLUNT TRAUMA Hematuria following blunt trauma may have different significance in the pediatric population. 67 Unlike the situation in adults, the degree of hematuria does seem to correlate with the degree of injury.5 Many advocate that pediatric patients with any degree of hematuria, even if hemodynamically stable, should undergo imaging studies.89 However, pediatric patients with less than 50 RBCs/hpf do not appear to have significant injuries. 5 Thus, it appears appropriate to perform imaging studies on only those patients with significant hematuria, as defined above. 3 Other standards for imaging studies for pediatric patients remain similar to those for adults.

Dealing With Back Pain

Dealing With Back Pain

Deal With Your Pain, Lead A Wonderful Life An Live Like A 'Normal' Person. Before I really start telling you anything about me or finding out anything about you, I want you to know that I sympathize with you. Not only is it one of the most painful experiences to have backpain. Not only is it the number one excuse for employees not coming into work. But perhaps just as significantly, it is something that I suffered from for years.

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