Abdominal Injuries

What should you remember about abdominal trauma injury assessments?

• Can be difficult to assess

• Limited protection of organs of abdomen

• Identifying that trauma has occurred is more important that identifying what structure is affected

  • Grimacing/verbal communication of pain

  • Redness/bruising

  • Bleeding

  • MOI

  • EXPOSE EXPOSE EXPOSE

• Significant intra-abdominal trauma may not show signs immediately - don’t rule out on vital signs alone

What are the three anatomical areas of the abdomen?

• Abdominal cavity

• Pelvis

• Retro-peritoneal area (Posterior region where organs are fixed e.g. vena cava and aorta, duodenum, pancreas, kidneys ureters bladder)

What is the risk to the retro-peritoneal area in trauma?

As structures are fixed in place tightly to the abdominal wall, high risk of shearing and rupturing

What can an internal bleed in the abdominal cavity result in for surrounding organs?

• Bleeding in abdo cavity can put pressure on other organs like the stomach

• Not leaving enough space for diaphragm to expand, affecting breathing

What should you remember about penetrating objects, I.e., a knife?

• Length of penetrating objects, for risk of injury to adjacent organs

• If object in situ do not remove, secure object

  • If pulsating, allow movement of object but still secure and do not remove

How should you manage evisceration injuries?

• Do NOT push protruding organs back in

• Apply Blast Dressing - do not wet as will become cold

  • Place plastic sheet against organ

  • Secure using the conforming bandage

How should you manage all abdo trauma incidents?

• Administer O2 high flow

• Analgesia as required

• Monitor vitals

• Apply relevant dressings if required

• Transport to appropriate hospital

What are some abdominal trauma red flags?

• Cat haem

• Major primary survey problems

• Decrease LOC

• Shoulder tip pain

• Tachycardia

• Dyspnoea

• Sats <94%

• Hypotension

• Abdo distension and bruising