Neobook — clinical reference

ASSESSMENT

The life-threatening consequences of Penetrating Abdominal Trauma are:

Suspect severe abdominal injury if: Penetrating injury to the abdomen or chest and any of the following:
Haemodynamic Instability, Peritoneal Signs or Intraperitonel Free Air
Evisceration
GIT Haemorrhage
Intra-abdominal Foreign Body
Macroscopic or Microscopic Haematuria

NB: Abdominal Injuries frequently accompany multiple other injuries: ALWAYS look for co-existing injuries.

The goal is to determine whether there Is a clinically significant intra-abdominal injury.

Use a standard ATLS Approach: Assess – Intervene – Reassess: Assessment and Management occur in tandem.
DeMIST handover from ambulance
TRIAGE PATIENT USING SATS SCORE
Measure and Record Vital Signs

Examination:

Primary: Assess ABCDE’S Then Secondary Head to Toe Examination

Specifically for Penetrating Abdominal Trauma:

Check haemodynamic status and Hb.
Look for potential sites of blood loss
Screen for External Bleeding (NB: Look at the back)
Screen for Internal Bleeding (Chest, abdomen, pelvis, long bones)
Abdominal examination: Distension, Discolouration, Tenderness, Rebound, Peritonism
Examine wound tract carefully to attempt to determine depth
Abdominal signs may be masked in head injury, intoxication or other severe injuries
PR exam to examine for blood PR
EFAST scan to look for intra-abdominal fluid, haemopericardium, haemothorax and pneumothorax

Attach: Monitors, ECG, SpO2, BP, Urine Catheter, NGT as needed

SAMPLE History:

INVESTIGATIONS:

MANAGEMENT