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Intra-abdominal

Injury
Contents
ABDOMINAL
ANATOMY
INTRA-ABDOMINAL INJURY
DEFINITION
TYPES
ASSESSMENT
MANAGEMENT
ABDOMINAL ANATOMY
ABDOMINAL QUADRANTS
What is Intra-Abdominal Injury?
Injury results from a
sudden increase of
pressure in the abdomen.

What is Intra-Abdominal Injury?


Blunt
Abdominal Injury
Blunt Abdominal Injury
-Occurs when the abdomen is
directly compressed or against
a fixed object.

Spleen
Kidneys
Liver
Motor
Vehicle
Accidents
SEAT BELT
INJURY
Penetrating
Abdominal Injury
Penetrating Abdominal Injury
-Occurs when objects
breaks the skin.

Liver
STAB WOUNDS

GUNSHOT WOUNDS

SIGNS
&
SYMPTOMS
Pain or
tenderness
Rigidity
Bleeding
Bruising
Evisceration
SIGNS
&
SYMPTOMS
SIGNS
&
SYMPTOMS
ASSESSMENT
HISTORY

If motor vehicle accident:


- Fatality at the scene
- Vehicle rolled over
- Patients location within the vehicle
- Extent of damage to the vehicle
- Steering wheel deformity
- Whether seat belts were used and, if so, what type?
- Whether air bags were deployed
ASSESSMENT
If penetrating trauma:
- No. of shots or stabs?
- Number of shots heard
- Position of the patient when shot?
- Distance of the patient from the gun
- What weapon was used?
- How long and how wide was the instrument?

ASSESSMENT
Inspection:
Percussion:
- Abdominal distention
- Rigidity - Dullness
-Abrasions or shifting dullness
- Ecchymosis Palpation:

- Tenderness
Auscultation:

- Rebound tenderness
- Auscultation of four
- Guarding or rigidity
quadrants
Management
FIRST AID
- Survey the scene -Stabilize the patient
- Do Primary Assessment -Cover protruding
- Activate Medical Assistance organs with wet cloth
and Transfer -Apply pressure to the
- Do Secondary Survey
wound that is bleeding
Management
Hospital

- Assess and document for obvious abnormalities


- Provide supplemental oxygen
- Assess for signs of shock
- Insert IV line
0.9% sodium chloride or lactated ringers
- Control the patients pain (morphine)
DIAGNOSTIC PROCEDURES

Hemoglobin & hematocrit levels


Serum Lactic Acid levels
ABG
DIAGNOSTIC PROCEDURES
Focused Abdominal Sonography for
Trauma

(FAST)
PLAIN FILMS
- CXR
- AXR
CT
DIAGNOSTIC PROCEDURES
Focused Abdominal Sonography for

Trauma (FAST)
PLAIN FILMS DIAGNOSTIC
- CXR PERITONEAL
- AXR LAVAGE (DLP)
CT
PHARMACOLOGY
ANALGESICS
- Morphine Sulfate
- Fentanyl
Broad Spectrum Antibiotics
- Ampicillin
- Tazobactam
Tetanus Toxoid Prophylaxis
MEDICAL MANAGEMENT
LAPAROSCOPY

&
EXPLORATORY LAPAROTOMY
Crush Injury
Contents Assessment

Pharmacology
Diagnostic Modalities
Complications
Management
Occurs when force or
pressure is put on a
body part.

Most often happens when


part of the body is
squeezed between two
heavy objects.
Assessment
Bleeding
Paralysis of a body part
Erythema and blistering
Damaged body part appearing
swollen, tense and hard
Infection
Pharmacologic Therapy
ANALGESICS
- Morphine Sulfate
- Fentanyl

ANXIOLYTICS
- Lorazepam

Diagnostic Modalities
Serum Creatinine
Kinase

Serum Lactic Acid Level


MedicalManagement
Fasciotomy
Complications
Hypotension and hypovolemic
shock
Renal Failure
Management
FIRST AID

- Survey the scene


- Do Primary Survey
- Activate Medical Assistance and Transfer
- Do Secondary Survey
Stabilize the patient
Rapid transport to trauma center

Management
use of tourniquet on the affected limb
Continue with fluid resuscitation while
transfer to a medical facility is
initiated.
“SCOOP and RUN”
Use of PPE is recommended

Management
SCOOP AND RUN
the patient is transported as fast
as possible to the hospital without
trying to stabilize him at the scene.
Management
STAY AND PLAY
patient receives treatment
and/or stabilization on scene before being
transported to the hospital.

Management
HOSPITAL
Stopping the bleeding
Establishing intravenous access and
initiation of fluid resuscitation prior to
releasing the crushed extremity
Isotonic fluids
Blood or blood products
Thank you for listening,
Future RNs.

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