Hyperglycemia and base deficit as prognostic markers in blunt abdominal trauma: A case report from an emergency department setting

Abstract

A 22-year-old female with an alleged history of a road traffic accident presented with a history of abdominal pain, which was sudden, diffuse, dull aching, aggravated by movements. At the time of presentation, her Primary survey was intact except for her blood pressure, which was 100/70 mmHg, pulse – 100 bpm. She also had a high blood glucose level. Fluid resuscitation was done with intravenous fluids and blood transfusions. The Extended Focused Assessment with Sonography in Trauma (E-FAST) was suggestive of fluid collection in the right hepatorenal pouch. Later on, the patient was hemodynamically unstable, and she was shifted to the operating theater. Blunt abdominal trauma presents with different presentations at the emergency department. The patient can present with mild abdominal pain with stable vital signs at initial presentation, but later experiences deterioration. Over 90% of all trauma patients may not be allocated correctly into the shock classes suggested by ATLS. Only 9.3% of patients are classified into shock classes. Early identification of hypovolemic shock in blunt abdominal trauma is crucial in the emergency department. High blood glucose and high base deficit can predict the prognosis in the emergency department.