Abdominal Injuries
By
Harold R. Knopp
Paramedic/ Firefighter, I/C
The Abdominal Organs
Retroperitonal Organs
Referencing ABD Areas
Types of Abdominal Injuries
• Closed injury
• Open injury
Closed ABD Injury
• Bleeding of organs is more commonly seen
in blunt trauma.
• Fractures to lower ribs can cause abd. Organ
injury.
• Seatbelts can injury internal organs.
• Unstable pelvis fractures can injury bladder,
blood vessels, bowel, and reproductive
organs.
Closed ABD
• The abdomen may become “Distended” if
there is blood, inflammation, or other
contents in the cavity.
• The abdomen can be “Distended” if all the
organs and vessels are intact!
The Open Abdominal Injury
• Ruptured hollow organs can spill contents
into cavity causing, “Peritonitis.”
• Any time the abdominal cavity is opened,
there is a prime consideration of infection!
• Key in treatment is stabilization of organs
and minimizing further blood loss.
S/S of ABD Injury
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Pain, tenderness
Nauseated, Emesis
Guarding
Fetal positioning
Coffee-ground emesis
Hematuria
Melena
Obvious trauma
• Lac, Bruises,
Deformity
• Tachypnea
• Distention
• Rigid abd
• Referred pain
• Hypovolemic shock
ABD Injury Management
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ABC, O2, Clear that emesis airway.
Assist vetilations as needed.
Keep them warm, calm, quiet.
Consider spinal immobilization.
Transport on side to reduce aspiration risk.
Control bleeding with direct pressure
dressings. Cold packs.
GSW to ABD
The Eviserated Bowel
Eviserated Bowel Care
• Always treat ABCs first!
• Goal of care is to:
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Stabilize organs.
Prevent further injury.
Keep bleeding to a minimum.
Conserve body heat loss!
• Always use sterile MOIST trauma dressing!
Another look
Care of Evisceration
Knife wounds can be Deceptive
When in doubt of Treatment Call
Rampart
Injuries to Genitalia
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Fractured Penis
Assault injuries
Self-inflicted amputation or mutilation
Burns
Lacerations, avulsed skin
Caring for injured Genitalia
• Desecration is the better part of valor.
• Ask before you do.
• Examining a sexual assault victim is not a
good idea, and may destroy evidence.
• Control bleeding, take parts and place in
sterile moist dressing, then in bag or jar.
• Minimize movement. Cold Packs.
The End