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HANNA · Credits: 1064636 My Scrapbook

Trauma and Oliguria

Options
a. Percutaneous nephrostomy
b. Suprapubic cystostomy
c. Urethral catheterization
d. Blood transfusion
e. Fluid challenge
f. 500 ml of IV mannitol
g. Walk around

1 Following an elective herniorraphy, a 67 yr old man is unable to pass urine. He is otherwise well.
The ans to this iswalk around…shouldn’t it be fluid challenge??

2. A man involved in a mining accident presents with oliguria and passing dark brown urine.

drhuman · Credits: 227 My Scrapbook

A.it think it is WALK AROUND as post op fluid retention is common
B.it it is is U.catheterisation

tania · Credits: 6620 My Scrapbook

1. walk around b/c i think u should try it first,if it fails then move to fluid challenge

2.fluid challenge...as pt. is oliguric

comments!

sajida · Credits: 106680 My Scrapbook My Reading List 6 Books

2--500ml of i/v mannitol

drhuman · Credits: 227 My Scrapbook

I THOUGHT THAT SINCE THE PATIENT IS PASSING BLOOD IN HIS URINE U.CTH WILL HALP TO JUDGE HOW MUCH IS THE FLUID OUT PUT AND URINARY ANALYSIS..FLUID CHALLENGE???IT MAY BE ..BUT HOW COME MANNITOL..PLEASE EXPLAIN

HANNA · Credits: 1064636 My Scrapbook

I think Sajida is right.
this is crush injury.
Mannitol is used in the treatment>>>produce an osmotic diuresis

sajida · Credits: 106680 My Scrapbook My Reading List 6 Books

yes dark brown urine is clue which is due to rhabdomyolysis common in crush injury but this is immediate rx and rx of choice is haemodialysis

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