Blunt Abdominal Trauma

Question 1

Blunt Abdominal Trauma

ASAP:

Answer 1

ABCs, 2 LB IVs, O2, monitor, VS, C-collar,   RSI/ ETT, full primary survey

Question 2

Blunt Abdominal Trauma

Hx / Exam:

Answer 2

Mxm of injury, SAMPLE hx, BS/symmetry, WOB, ext bleeding, FAST, pulses, seat belt sign, GCS/gross neuro, pelvis,
rectal/log roll, meatus; full secondary survey, serial FAST and abd exams

Question 3

Blunt Abdominal Trauma

Labs:

Answer 3

CBC, BMP, LFT, coags, EtOH, T&C/S, lipase, UA, hCG,   DPL for RBCs

Question 4

Blunt Abdominal Trauma

Rads:

Answer 4

pCXR, CT abd/pelvis (if stable)

Question 5

Blunt Abdominal Trauma

Tx:

Answer 5

Foley and G-tube

Question 6

Blunt Abdominal Trauma

ABX if bowel injury suspected:

Answer 6

Cefoxitin 2gm IV (peds 40 mg/kg) OR Unasyn 3 gm IV (peds: < 2y 100 mg/kg, <12y 150 mg/kg)

Question 7

Blunt Abdominal Trauma

Tx:
If FAST (or DPL) + and pt unstable…

Answer 7

→ OR

Question 8

Blunt Abdominal Trauma

Further workup
if FAST (or DPL) + and pt stable…

Answer 8

→ CT

Question 9

Blunt Abdominal Trauma

Urgent surgical consult if…

Answer 9

Peritoneal signs, unstable VS, pneumoperitoneum, diaphragm injury, + FAST or bleeding on CT DPL +
if…> 100,000 RBC/hpf or frank blood or succus