Ministry of Health

http://newzealand.govt.nz/

    
 ©Copyright
 Published: 28/11/2011

DPL technique

1. Ensure that the patient has a gastric tube and urinary catheter in place
2. Prep the abdomen with Betadine and drape the umbilical region.
3. Inject local anaesthetic with adrenaline in the midline subumbilical
     region (supraumbilical if pelvic fracture present).
4. Vertically incise the skin and subcutaneous tissue down to the fascia.
5. Insert a small self-retaining retractor to hold the tissues open and stop
     any bleeding.
6. Incise the fascia and identify the peritoneum. Insert a purse-string
     suture to stop leakage of lavage fluid.
7. Make a small hole in the peritoneum and insert the lavage catheter,
     directing it into the pelvis.
8. Connect the catheter to a syringe and aspirate.
9. If < 10mls of frank blood is aspirated instil 1 litre of warmed crystalloid
     and agitate the abdomen gently.
10. Allow the fluid to siphon off. At least 250mls must be removed for the
     lavage result to be representative.
11. Remove the catheter and suture the fascia and skin.
see FAST