Chapter 31: Abdominal & Genitourinary Injuries Flashcards
What organs are found in the right upper quadrant?
Gallbladder, duodenum of intestines, majority of liver, small portion of pancreas
What organs are found in the left upper quadrant?
spleen, most of stomach, larger portion of pancreas
What organs are found in the right lower quadrant?
portions of large and small intestines- ascending colon and right half of transverse colon, appendix
What organs are found in the left lower quadrant?
portions of the large and small intestines– descending colon and left half of transverse colon
What is peritonitis?
Inflammation and pain of the lining of the peritoneum due to rupture or laceration of hollow organs
What may abdominal distension and rigitiy indicate?
Inflammation or internal bleeding into the cavity
What external findings should make you suspect kidney damage?
Abrasion, laceration, or contusion in the flank
Penetrating wound in flank or upper abdomen
Fraction on either side of lower rib cage or of the lower thoracic or upper lumbar vertebrae
Hematoma in flank region
What is important to report about the MOI of an abdominal and genitourinary traumatic emergency?
Velocity
Low: hand propelled (ie knives)
Medium: small caliber handguns and shotguns
High: High caliber handgun and rifles
What may internal injuries do over time? So what must you do?
Get worse. CRITICAL: Reassess often: Primary, secondary, interventions
What is very important with a secondary assessment of a traumatic emergency?
EXPOSE the injury trauma naked
Position of comfort may be lying with knees drawn to chest
Look for entrance and exit wounds
What is important about an evisceration?
Do not push on abdomen–visual assessment only. Cut clothes away without pulling
What is a cavitation?
Pressure wave from a projectile causing large amount of bleeding
What are the aspects of a physical exam of an abdominal genitourinary injury?
Palpate from farthest quadrant
DCAP-BTLS
Head to toe exam
Treat life threats as you find them
What is general treatment for an abdominal genitourinary injury?
Call ALS, monitor ABCs and LOC, treat for shock, and rapid transport
What is treatment for an open wound abdominal genitourinary injury?
Check for entry and exit wounds, keep organs moist and warm, cover with sterile gauze, secure with a bandage, cover with occlusive dressing if needed
What indicates kidney injury?
Abrasion, laceration, contusion on flank
Penetrating wound: flank/upper abdomen
Rib fracture: lower rib cage
Side tackle in foot ball
What indicates bladder injuries?
Men: sudden deceleration can sheer urethra from bladder
Women: pregnancy increases potential for injury
What is important about external male genitalia trauma?
Soft-tissue wounds, painful, rarely life threatening, distracting injury
What is inportant about female genitalia?
Internal organs rarely injured-except uterus when pregnant,
External: Use sanitary pad to stop bleeding
-do not insert anything into vagina
Same gender EMT evaluate if possible
Examine undergarments for blood
What is important about assessments of genitourinary injuries?
Patients may provide MOI less embarrassing than actual MOI, vascular areas, if blood present exterior genitals must be inspected, was this a sexual assault, are parents present
What are the common complaints of a genitourinary injury?
Nausea, vomiting, diarrhea, blood in urine or vomit, abnormal bowel and bladder habits
What is important in an instance of sexual assault?
Emotional support necessary, don’t examine genitalia unless bleeding requires intervention, don’t allow patient to wash, urinate, defecate, eat, drink, mouthwash, brush teeth, handle pt clothing as little as possible`
