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ABDOMINAL TRAUMA the diaphragm is raised on the left side, to keep this
from happening
Course Outline Child notices radiated left shoulder pain while lying
in a supine position (Kehr’s sign)
Definition
Assessment Note: Broken rib over the spleen suggesting the extent of the
Diagnostics trauma.
Complications of Abdominal Trauma
- Splenic Rupture Diagnostics
- Live Rupture
□ IV pyelogram
□ MRI
□ FAST
DEFINITION □ CBC
It is a result from object striking the abdomen, such as □ Blood typing
baseball bat or a seatbelt drawn tight in a motor vehicle
crash. Management
Admission
ASSESSMENT IVF
Assess vital signs frequently until stable “E” explore laparotomy
Hypotension (less than 80mmHg systolic Antibiotics
pressure in an older child; less than 60mmHg in
an infant) usually suggests hemorrhage, which LIVER RUPTURE
may be hidden abdominal bleeding
- More prone to rupture in children rather than adults
May have increasing pallor
- Because it is not completely not shattered by the rib
May have rapid respirations
cage.
If internal bleeding is present, blood pressure will
show little improvement when IV fluid is Assessment
administered.
Nasogastric Tube (NGT) is passed and stomach Severe abdominal pain that is most marked on
contents are aspirated to be checked visually for inspiration, when the diaphragm descends and
blood and to test for occult blood touches the liver
Low intermittent suction was done to if Symptoms of blood loss: tachycardia, hypotension,
presence of blood is established. anxiety and pallor
Foley Catheter (IFC) is also inserted to evaluate urine Hematocrit is low or falling
for blood and urine output
Evidence of blood in the urine or decreased Note:
output may indicate accompanying kidney or
bladder trauma. - Communication between an artery and the bile duct occurs
at the time of trauma. (symptoms are not immediate)
DIAGNOSTICS - Gastrointestinal (GI) bleeding such as hematemesis or
melena, may occur in a few days
□ Abdominal X-Ray
□ FAST - May have colicky upper abdominal pain that is relieved by
□ Pelvic X-Ray emesis
SPLENIC RUPTURE
- Most frequently injured organ, because it is usually
palpable under the lower left ribs
- Frequently injured by inappropriately applied seat
belts and by handlebar injuries in bicycle accidents
Assessment
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