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Abdominal Trauma, History, Positioning, Abdo assessment - Coggle Diagram
Abdominal Trauma
Hollow organs
Bile duct
Fallopian tubes
Gallbladder
Ureter
rarely damaged by blunt trauma as deep and protected
Colon
Stomach
Typically effected by penetrating trauma
Peritonitis
Bladder
Related to pelvic #
Small intestine
Concern: seat belt bruising
Lower pack pain
Pain
Intermittent
Comes on in waves
Ache
Breakthrough sharp pain
Often severe
Appendix
Peritonitis
Solid organs
Liver
Concern: lower rib #
1.4l/min blood
Kidneys
Spleen
Concern: lower rib #
Low mechanism
Pancreas
4% blunt trauma effects pancreas
Uterus
Adrenal gland
Ovaries
Pain
Dull ache
Constant
Throbbing
Haemorrage +++
Penetrating trauma
Consider injury to chest a possible abdo injury
Can bleed profusely
Eviscerated bowel
Strangulation
Cover with wet dressing - do not let it dry
Blunt trauma
Common MOI's
MVC
Assault
Falls
Genito urinary
Gastro intestinal
History
MOI
Greater than 20kph
Head, chest or leg injuries
Age >75
Unconscious
Assume abdo injury
Clear injuries above and below abdo
Kehr's sign
L shoulder tip pain from diaphragmatic irritation
Consider distracting injury
Positioning
Effective analgesia
Transport to destination - major trauma
Assistance
Long term analgesia
Fluids
TXA
Shock
Consider pelvic splint
Primary Survey
Time Critical
Management
Treat en-route
Abdo assessment
Split into 9 quadrants
Look
Auscultate
Percuss
Feel
Initial light palpation
Tenderness
Guarding
Deep palpation
Tenderness
Guarding
Rebound tenderness
https://www.youtube.com/watch?v=XOefpxm38bc
Although this is an advanced assessment
Advanced skills
Advanced skills
Distension
unreliable
Colour
Bruising
slow onset
Wounds
Abdo, back and flanks
Expose
Scars
Cullens Sign
Bruising around umbilicus
Slow onset
Grey Turner's Sign
Bruising lower abdo and flanks
Slow onset
Guarding
ASK