Management of PAT.pdf

2. What is Penetrating Abdominal Trauma Result of trauma from an object puncturing the skin entering the body, and creating a wound The projectile passes through tissue and decelerates, transferring kinetic energy into the tissue Lacerations Abdominal bleeding Bowel evisceration Abdominal bruising Signs of peritonitis (abdominal tenderness, distension, rigidity, guarding, fever) Hemodynamic instability ABDOMINAL TRAUMA COURSE: TRAUMA

3. DIAGNOSIS HISTORY PHYSICAL EXAM Mechanism of trauma History of previous trauma Drug (illicit and prescription) or alcohol use by patient Prior surgical history Amount of blood loss (on scene per paramedics and in hospital) AIRWAY BREATHING CIRCULATION Examining the patient head to toe External Injury should Prompt investigation for corresponding internal injury Signs for concerning for sever intra abdominal injury ABDOMINAL TRAUMA COURSE: TRAUMA

4. Fluid Resuscitation Insertion of 2 Large IV lins Fluid Administration Replenish Blood Broad Sprectrum Anti Biotics Tetanus Prophylaxis 1. a. b. c. 2. 3. ABDOMINAL TRAUMA COURSE: TRAUMA MANAGEMENT

5. Hemodynamically unstable Emergent Exploratory Laparatomy MANAGEMENT Fluid Resuscitation Insertion of 2 Large IV lins Fluid Administration Replenish Blood Broad Sprectrum Anti Biotics Tetanus Prophylaxis 1. a. b. c. 2. 3. ABDOMINAL TRAUMA COURSE: TRAUMA

6. Hemodynamically unstable Emergent Exploratory Laparatomy Hemodynamically stable Check for Penetration in Peritonial Space Fluid Resuscitation Insertion of 2 Large IV lins Fluid Administration Replenish Blood Broad Sprectrum Anti Biotics Tetanus Prophylaxis 1. a. b. c. 2. 3. ABDOMINAL TRAUMA COURSE: TRAUMA MANAGEMENT

7. Hemodynamically unstable Emergent Exploratory Laparatomy Hemodynamically stable Check for Penetration in Peritonial Space FAST EXAM Fluid Resuscitation Insertion of 2 Large IV lins Fluid Administration Replenish Blood Broad Sprectrum Anti Biotics Tetanus Prophylaxis 1. a. b. c. 2. 3. LWE ABDOMINAL TRAUMA COURSE: TRAUMA MANAGEMENT

8. Hemodynamically unstable Emergent Exploratory Laparatomy Hemodynamically stable Check for Penetration in Peritonial Space FAST EXAM Fluid Resuscitation Insertion of 2 Large IV lins Fluid Administration Replenish Blood Broad Sprectrum Anti Biotics Tetanus Prophylaxis 1. a. b. c. 2. 3. LWE if no peritoneal penetration Clean and close the wound if with peritoneal penetration Conduct CT Scan Observation Abdominal Examinations 1. 2. 3. ABDOMINAL TRAUMA COURSE: TRAUMA MANAGEMENT

9. Hemodynamically unstable Emergent Exploratory Laparatomy Hemodynamically stable Check for Penetration in Peritonial Space FAST EXAM Fluid Resuscitation Insertion of 2 Large IV lins Fluid Administration Replenish Blood Broad Sprectrum Anti Biotics Tetanus Prophylaxis 1. a. b. c. 2. 3. LWE if no peritoneal penetration Clean and close the wound if with peritoneal penetration Conduct CT Scan Observation Abdominal Examinations 1. 2. 3. Hemodynamically stable DISCHARGE ABDOMINAL TRAUMA COURSE: TRAUMA MANAGEMENT

10. Fluid Resuscitation Insertion of 2 Large IV lins Fluid Administration Replenish Blood Broad Sprectrum Anti Biotics Tetanus Prophylaxis 1. a. b. c. 2. 3. ABDOMINAL TRAUMA COURSE: TRAUMA MANAGEMENT

11. Hemodynamically unstable Emergent Exploratory Laparatomy Fluid Resuscitation Insertion of 2 Large IV lins Fluid Administration Replenish Blood Broad Sprectrum Anti Biotics Tetanus Prophylaxis 1. a. b. c. 2. 3. ABDOMINAL TRAUMA COURSE: TRAUMA MANAGEMENT

12. Hemodynamically unstable Emergent Exploratory Laparatomy Hemodynamically stable Check for Peritoneal Perforation Fluid Resuscitation Insertion of 2 Large IV lins Fluid Administration Replenish Blood Broad Sprectrum Anti Biotics Tetanus Prophylaxis 1. a. b. c. 2. 3. ABDOMINAL TRAUMA COURSE: TRAUMA MANAGEMENT

13. Hemodynamically unstable Emergent Exploratory Laparatomy Hemodynamically stable Check for Peritoneal Perforation CT SCAN Fluid Resuscitation Insertion of 2 Large IV lins Fluid Administration Replenish Blood Broad Sprectrum Anti Biotics Tetanus Prophylaxis 1. a. b. c. 2. 3. ABDOMINAL TRAUMA COURSE: TRAUMA MANAGEMENT

14. Hemodynamically unstable Emergent Exploratory Laparatomy Hemodynamically stable Check for Peritoneal Perforation CT SCAN Fluid Resuscitation Insertion of 2 Large IV lins Fluid Administration Replenish Blood Broad Sprectrum Anti Biotics Tetanus Prophylaxis 1. a. b. c. 2. 3. if no peritoneal penetration if with peritoneal penetration ABDOMINAL TRAUMA COURSE: TRAUMA MANAGEMENT

15. Hemodynamically unstable Emergent Exploratory Laparatomy Hemodynamically stable Check for Peritoneal Perforation CT SCAN Fluid Resuscitation Insertion of 2 Large IV lins Fluid Administration Replenish Blood Broad Sprectrum Anti Biotics Tetanus Prophylaxis 1. a. b. c. 2. 3. if no peritoneal penetration if with peritoneal penetration Hemodynamically stable DISCHARGE Serial Abdominal Exams ABDOMINAL TRAUMA COURSE: TRAUMA MANAGEMENT

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Management of PAT.pdf