Post on 23-Jan-2016
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Chapter 23
Abdomen and Genitalia Injuries
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Chapter 23: Abdomen and Genitalia Injuries
• State the steps in the care of a patient with a blunt or penetrating abdominal injury.
• Describe how solid and hollow organs can be injured.
• State the steps in the care of a patient with an object impaled in the abdomen.
• State the steps in the care of a patient with an abdominal evisceration wound.
Objectives (1 of 2)
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Chapter 23: Abdomen and Genitalia Injuries
Objectives (2 of 2)
• State the steps in the care of a patient with a genitourinary injury.
• Demonstrate proper treatment of a patient who has an object impaled in the abdomen.
• Demonstrate how to apply a dressing to an abdominal evisceration wound.
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Chapter 23: Abdomen and Genitalia Injuries
Hollow Organs in the Abdominal Cavity
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Chapter 23: Abdomen and Genitalia Injuries
Signs of Peritonitis• Abdominal pain
• Tenderness
• Muscle spasm
• Diminished bowel sounds
• Nausea/vomiting
• Distention
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Chapter 23: Abdomen and Genitalia Injuries
Solid Organs in the Abdominal Cavity
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Chapter 23: Abdomen and Genitalia Injuries
Abdominal Quadrants
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Chapter 23: Abdomen and Genitalia Injuries
Injuries of the Abdomen
• Closed injury (blunt)
– Severe blows that damage the abdomen without breaking the skin
• Open injury (penetrating)
– Foreign body enters the abdomen and opens the peritoneal cavity to the outside
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Chapter 23: Abdomen and Genitalia Injuries
Signs and Symptoms of Abdominal Injury
• Pain
• Tachycardia
• Decreased blood pressure
• Pale, cool, moist skin
• A firm abdomen on palpation
• Bruising
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Chapter 23: Abdomen and Genitalia Injuries
Evaluating Abdominal Injuries (1 of 2)
• Determine the type of injury, extent of damage, and presence of shock.
• Keep airway clear and watch for vomiting.
• Place patient supine with knees bent.
• Obtain baseline vital signs.
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Chapter 23: Abdomen and Genitalia Injuries
Evaluating Abdominal Injuries (2 of 2)
• Follow DCAP-BTLS.• Inspect abdomen for wounds.• Immobilize any impaled objects.
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Chapter 23: Abdomen and Genitalia Injuries
Blunt Abdominal Wounds (1 of 2)
• Severe bruises of the abdominal wall
• Laceration of the liver and spleen
• Rupture of the intestine
• Tears in the mesentery
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Chapter 23: Abdomen and Genitalia Injuries
Blunt Abdominal Wounds (2 of 2)
• Rupture or tearing of the kidneys
• Rupture of the bladder
• Severe intra-abdominal hemorrhage
• Peritoneal irritation and inflammation
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Chapter 23: Abdomen and Genitalia Injuries
Care of Blunt Abdominal Wounds
• Place patient on backboard.
• Protect airway.
• Monitor vital signs.
• Administer oxygen.
• Treat for shock.
• Arrange for prompt transport.
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Chapter 23: Abdomen and Genitalia Injuries
Seat Belts and Airbags
• If used inappropriately, seat belts may cause injuries.
• Frontal airbags provide protection only during head-on collisions.
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Chapter 23: Abdomen and Genitalia Injuries
Abdominal Evisceration• Internal organs or fat protrude through the
open wound.
• Never try to replace organs.
• Cover the organs with a moist gauze, then secure with a dressing.
• Organs must be kept warm and moist.
• Arrange for prompt transport.
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Chapter 23: Abdomen and Genitalia Injuries
Anatomy of the Genitourinary System
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Chapter 23: Abdomen and Genitalia Injuries
Injuries to the Kidneys• Suspect kidney damage if patient has a
history or physical evidence of:
– Abrasion, laceration, or contusion in the flank
– A penetrating wound in the region of the lower rib cage or upper abdomen
– Fractures on either side of the lower rib cage or of the lower thoracic or lumbar vertebrae
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Chapter 23: Abdomen and Genitalia Injuries
Injury of the Urinary Bladder• Blunt or penetrating injury can rupture the
bladder.
• Urine will spill into surrounding tissues.
• Suspect injury if you see blood at the urethral opening or physical signs of trauma on the lower abdomen, pelvis, or perineum.
• Monitor vital signs.
• The presence of associated injuries or shock will dictate the urgency of transport.
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Chapter 23: Abdomen and Genitalia Injuries
Male Reproductive System
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Chapter 23: Abdomen and Genitalia Injuries
Caring for Injury to the External Male Genitalia
• These injuries are painful; make patient comfortable.
• Use sterile, moist compresses to cover areas stripped of skin.
• Apply direct pressure to control bleeding.
• Never manipulate any impaled objects.
• Identify and bring avulsed parts to the hospital.
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Chapter 23: Abdomen and Genitalia Injuries
Female Reproductive System
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Chapter 23: Abdomen and Genitalia Injuries
Injuries of the Female Genitalia
• Female internal genitalia are well protected and usually not injured.
• The exception is the pregnant uterus, which is vulnerable to both blunt and penetrating injuries.
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Chapter 23: Abdomen and Genitalia Injuries
Genitalia Injuries in Pregnant Women
• Keep in mind that the unborn child is also at risk.
• Expect to see signs and symptoms of shock.
• Provide all necessary support.• Place the mother on her left side to reduce
pressure on her vena cava.• Arrange for prompt transport.
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Chapter 23: Abdomen and Genitalia Injuries
Caring for Injuries of the Female Genitalia (1 of 2)
• Injuries to the external genitalia are very painful but not usually life threatening.
• Treat lacerations, abrasions, and avulsions with moist, sterile compresses.
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Chapter 23: Abdomen and Genitalia Injuries
Caring for Injuries of the Female Genitalia (2 of 2)
• Use local pressure and a diaper-type bandage to hold dressing in place.
• Urgency of transport will be determined by associated injuries, amount of hemorrhage, and presence of shock.