1. poor evaluation for retroperitioneal injury
2. types
2.1. blunt trauma
2.1.1. motor vehicle collisions
2.1.2. falll
2.1.3. physical abuse
2.2. penetrating
2.2.1. single or multiple injuries
2.2.2. gunshot wounds
2.2.3. stab wounds
3. sings and symptoms
3.1. general manifestation
3.1.1. tachypnea
3.1.2. tachycardia
3.1.3. hypotension
3.1.4. cold skin
3.1.5. decreased UOP
3.2. specific manifestation
3.2.1. inspection
3.2.1.1. bruises
3.2.1.2. abrasions
3.2.1.3. open wounds
3.2.1.4. distension
3.2.2. palpation
3.2.2.1. rebound pain
3.2.2.2. masses
3.2.2.3. rigidity
3.2.2.4. pelvic instability
3.2.3. auscaltation
3.2.3.1. decreased or absent bowel sound
4. diagnostic studies for abdominal trauma
4.1. FAST
4.1.1. good sensitivity and specificity
4.1.2. poor evaluation for hollow viscous and retropertitioneal injury
4.2. DPA
4.2.1. hollow viscous injury detection
4.2.2. high sensevity and specificity
4.3. CT Scan
4.3.1. great sensevity and specificity
4.3.2. detect hollow viscous and retroperitoneal injury
5. determine past medical history
6. therapeutic interventions
6.1. laceration & rupture
6.1.1. prepare for surgical intervention
7. assessment and manegement
7.1. airway and breathing
7.1.1. assess and secure airway
7.1.2. check response
7.1.3. chest movement and breath sounds
7.1.4. look for airway obstruction
7.1.5. look for airway obstruction
7.1.6. assess and secure airway
7.2. circulation
7.2.1. assess circulation
7.2.2. obtain a minimum of 2 IV lines
7.2.3. send for blood group & cross match
7.2.4. administer warm lacted ringer or NS
7.2.5. administer blood as needed
7.2.6. stabilize penetrating object if present
7.3. disability
7.3.1. assess LOC , pupils size , reaction
7.3.2. initiate or maitain spinal immobilization
7.4. exposure and environmetal control
7.5. other management
7.5.1. identify mechanism of injury
7.5.2. cover open adominal wounds
7.5.3. place orogastic tube
8. spicific abdominal injury
8.1. 1/ spleen injury
8.1.1. singns and symptoms
8.1.1.1. signs of peritoneal irritation
8.1.1.2. left upper quadrant pain and tenderness
8.1.1.3. signs of hypovolemic shock
8.1.2. diagnostic studies
8.1.2.1. abdominal ultrasound
8.1.2.2. ct scan
8.1.3. therapeutic interventions
8.1.3.1. hemodynamically stable patient
8.1.3.1.1. admit for close observation
8.1.3.1.2. obtain blood sample for serial hematocrit tests
8.1.3.1.3. facilitate repeated ct scans
8.1.3.2. hemodynamically unstable patient
8.1.3.2.1. prepare for surgical intervention
8.1.3.2.2. administer a pneumovax vaccination
8.2. 2/ liver injuries
8.2.1. signs and symptoms
8.2.1.1. right upper quandeant pain
8.2.1.2. signs of shock
8.2.1.3. signs of peritoneal irritation
8.3. signs and symptoms
8.3.1. flank tenderness
8.3.2. ecchymosis over flank area
8.3.3. palpable mass
8.3.4. hematuria
8.3.5. hemorrhage & urine , extravasation
8.4. 3/ kidney injures
8.4.1. diagnostic studies
8.4.1.1. IV pyelogram
8.4.1.2. urine analysis
8.4.1.3. ct scan
8.4.2. therapeutic interventions
8.4.2.1. laceration
8.4.2.1.1. surgical repair or nephroectomy
8.5. 4/ pancrease injury
8.5.1. signs and symptoms
8.5.1.1. epigastric pain
8.5.1.2. nausea & vomiting
8.5.1.3. abdominal distention
8.5.1.3.1. contusions
8.5.1.4. altered vital signs
8.5.1.5. serial serum amylase
8.5.2. therapeutic interventions
8.5.2.1. blunt trauma
8.5.2.1.1. admit for close observation
8.5.2.2. penetrating injuries
8.5.2.2.1. prepare for immediate surgical interventions