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14 Cards in this Set
- Front
- Back
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What are injuries to the abdomen categorized as?
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Blunt or penetrating trauma. Blunt is the most common mechanism of injury.
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What can cause blunt trauma?
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Blunt injury can occur from direct compression of the abdomen with fracture of solid organs and blowout of hollow organs.
Also deceleration forces causing tearing of organs and their blood vessels. |
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What can give you a false sense of security with blunt abdominal injuries?
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The patient may have no pain and little evidence of external injury.
Patients with multiple lower rib fractures are notorious for having severe intra-abdominal injuries without significant abdominal pain. The patient may bleed to death because abdominal injuries were not recognized. |
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What are most penetrating injuries caused by?
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Gunshot or stab wounds. Gunshot wounds have a higher mortality due to the larger energies that are involved and greater damage to surrounding tissue and organs.
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What can patients develop as a result of stab or gunshot wounds to the abdomen?
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Life threatening peritonitis
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What should you look for with penetrating injuries?
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Look for an exit wound and try to work out the path of the object.
Take C-Spine precautions if the injury is located anywhere where the spine could be compromised. |
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What are some things that can be identified from the scene assessment?
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Has the patient fallen from height or been hit by a motor vehicle?
Has the patient been hit by a blast that threw them against a wall or damaged internal organs? Were they in an MVC and wore their seat belt under the arm rather than over it? Was the lap belt too high over the abdomen rather than the pelvis? Look at the damage to the vehicle. Were airbags deployed, location of occupants, intrusion into passenger areas, bent steering wheel or column? |
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What should you note with gunshot wounds?
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Try to find out the caliber of the bullet, the range of the shot and the number of rounds fired.
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What do you need to report to the emergency department?
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Any circumstances that lead you to believe that there may be abdominal injury.
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What are some signs of abdominal trauma / injury?
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Distention, Tenderness or tenseness of the abdomen... should be interpreted as a sign of severe hemorrhage
Instability or crepitus in the palpation of the pelvis may be a fracture. Pelvic fractures frequently result in hemorrhagic shock |
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When do signs of intra-abdominal injury appear?
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They do not usually appear early therefore if signs are present in pre-hospital care the patient may have been there a while or the injury is significant.
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What patients can present with a lack of tenderness?
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Altered LOC and spinal injury patients or those with a distracting injury
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How is abdominal trauma stabilized in the field?
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It cannot be stabilized in the field. Interventions should follow the standard path for ITLS
Secure the Airway Provide High Flow O2 assisting ventilations if needed Start two large bore IV's at TKVO Rapid transport If the BP drops below 90 then fluids should be given to raise the blood pressure to 90-100 |
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How should you care for an evisceration?
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Gently cover any organ or viscera protruding from a wound with gauze moistened with saline or water.
If long transport time then can apply a plastic wrap or aluminum foil to prevent drying off of the gauze and intestines If there is an impalement such as a knife in the abdomen it should be stabilized and not removed. |
