Trauma - Abdominal:
HX - Mechanism of injury, associated trauma, penetrating vs blunt injury? Suspect internal hemorrhage. Guarding distentsion, rigidity, hypotension, pallor, bruising?
RUQ - Liver, gallbladder, duodenum, head of panceras, right kidney (posteriorly) asending colon, transverse colon.
LUQ - Stomach, tail of pancreas, liver, left kidney (posteriorly), spleen, transverse colon, desending colon.
LLQ - small intestine, decending colon, left ovary, fallopian tube.
RLQ - appendix, cecum, right ovary, fallopian tube, small intestine.
Midline - Great vessels (arota, vena cava) bladder, uterus.
Back - Kidneys, spleen, on left side
+ - Vitals, 02, IV, treat for shock, transport.
Trauma Chest:
HX - MOI: estimate forces involved. Lung Disease?
Resporatory distress? Pain? Use of accessory muscles?
LOC, color, GCS, is pt. anxious?
Tracheal shift? Symmetrical cx expansion? JVD? Lung sounds? Hemoptysis? Sub Q emphysema &/or crepitus?
Life Threatening chest injuries:
-Flail Segment
-Open Chest Wounds
-Tension pneumothorax
+ Secure airway, high flow O2, intubate if necessary and assist ventilations
Open Chest Wound: Cover with occlusive dressing. Look for exit Wounds.
Tension pneumothorax: Evaluate and decompress
Impaled objects: stabilize in place. Do not delay transport if pt. is unstable. Consider IV Fluids for shock (2 large bore IVs( Monitor EKG, Vitals, Full spinal Immobilization.
Caution--Consider other causes for respiratory distress
