شاب عمره ٢٠ سنة سقط على خاصرته اليسرى من دراجة نارية. يشتكي ألماً في الخاصرة، وفي البول دم واضح، وهناك كدمة على الخاصرة. الضغط ٩٦/٦٠، والنبض ١١٨، والهيموغلوبين نزل من ١٤ إلى ١١. ما الإجراء الأهم؟

A 20-year-old fell onto his left flank from a motorcycle. He has flank pain, gross haematuria and a flank bruise. BP 96/60, HR 118, Hb fell from 14 to 11. What is the most important action?

1. Encourage walking to improve drainage from the kidney
2. Insert a catheter and irrigate the bladder to clear blood only
3. Frequent monitoring of vitals and haemoglobin with an urgent CT scan
4. Analgesia and discharge home with plenty of water

Answer: C) Frequent monitoring of vitals and haemoglobin with an urgent CT scan. Renal trauma with haematuria and shock signs needs urgent contrast CT and close monitoring of BP, pulse and Hb, with blood and surgery prepared as needed.