- Suspect GU injury (often occult)
- Look for hematuria
- Stability permitting, evaluate the GU tract in a retrograde fashion
- Become proficient with ED procedures (retrograde urethrogram & cystogram)
- Know the strengths and pitfalls of the studies you select
- Recognize that pelvic ring fractures are a major cause of M&M
- Associated GU injury common
- Identify the injury type on X-ray:
- AP compression
- Vertical shear
Resuscitation essentials:
- Anticipate and treat shock
- Use the FAST to identify the major source(s) of hemorrhage
- Transfer to an appropriate center
- Early pelvic stabilization
- Identify and prioritize injuries
- Mobilize resources (e.g.: angiography)