HISTORY
PHYSICAL EXAM
Assessment should be systematic and constant with re-evaluation.
Breathing- Are respirations effective? Does the patient require assistance or ventilation?
Circulation- Monitor for signs of hypovolemic shock as these patients are high risk.
Disability- Perform a quick neuro assessment as well as LOC and motor function evaluations.
Exposure and Evacuation- Undress patient to see injuries, consider transport if necessary.
Inspect the perineum for accompanying urinary tract injuries that may lead to bleeding from the urinary meatus, vagina, and rectum.
Auscultate for bowel sounds for 2 minutes- note location and activity.
- AMPLE trauma assessment: Allergies; Medications; Past medical history; Last meal; Events leading to presentation.
- Type of trauma (blunt or penetrating).
- For MVA patients, determine the speed and type of the vehicle, whether the patient was restrained, the patient's position in the vehicle, and whether the patient was thrown from the vehicle on impact. If the patient was injured in a motorcycle crash, determine whether the patient was wearing a helmet.
PHYSICAL EXAM
Assessment should be systematic and constant with re-evaluation.
- Primary Survey:
Breathing- Are respirations effective? Does the patient require assistance or ventilation?
Circulation- Monitor for signs of hypovolemic shock as these patients are high risk.
Disability- Perform a quick neuro assessment as well as LOC and motor function evaluations.
Exposure and Evacuation- Undress patient to see injuries, consider transport if necessary.
- Secondary Survey: Full assessment of all organ systems.
Inspect the patient's abdomen, note distention, lacerations, ecchymoses, and penetrating wounds.
Inspect the perineum for accompanying urinary tract injuries that may lead to bleeding from the urinary meatus, vagina, and rectum.
Auscultate for bowel sounds for 2 minutes- note location and activity.
- Intra-abdominal Hypertension (IAH) Assessment (see below) - These are guidelines developed by the World Society of the Abdominal Compartment Syndrome. Nurses are recommended to use this algorithm when caring for patients suspected of having IAH.
PSYCHOSOCIAL
Social support is important while the patient undergoes invasive treatment and will be necessary to deal with any body image distortions that may results from scars, ostomies, etc. The nurse should assess these support systems or lack there-of regularly to determine prevention of psychosocial diagnoses.
Social support is important while the patient undergoes invasive treatment and will be necessary to deal with any body image distortions that may results from scars, ostomies, etc. The nurse should assess these support systems or lack there-of regularly to determine prevention of psychosocial diagnoses.
Sources:
Unbound Medicine. (2011). Abdominal Trauma. Retrieved from http://nursing.unboundmedicine.com/nursingcentral/ub/view/Diseases-and-Disorders
/73502/all/Abdominal_Trauma?q=blunt%20abdominal%20trauma
World Society of the Abdominal Compartment Syndrome. (2013). Information for Patients and Families. Retrieved from http://www.wsacs.org
/for-patients.html
Unbound Medicine. (2011). Abdominal Trauma. Retrieved from http://nursing.unboundmedicine.com/nursingcentral/ub/view/Diseases-and-Disorders
/73502/all/Abdominal_Trauma?q=blunt%20abdominal%20trauma
World Society of the Abdominal Compartment Syndrome. (2013). Information for Patients and Families. Retrieved from http://www.wsacs.org
/for-patients.html