Abdominal examination

Assessing abdominal injuries can sometimes be challenging. During the initial examination, signs indicating an injury may not be immediately apparent, even in cases of significant injury. Therefore, it is crucial to assess the location of the incident and the mechanism of injury.

Based on the mechanism of injury, if the accident involved significant force, we can expect injuries that may not be immediately noticeable. If we notice internal deformations in the vehicle, such as a deformed steering wheel, we should suspect chest and abdominal injuries.

Abdominal injuries, depending on whether the integrity of the skin of the abdominal wall is preserved, can be categorized as open or closed injuries. They can also be classified based on:

  1. Penetrating or non-penetrating injuries, depending on whether the peritoneum is injured.
  2. Perforating or non-perforating injuries, depending on whether a hollow organ is injured.
  3. According to the mechanism of injury: stab wounds, gunshots, lacerations and contusions.
  4. Based on the extent of injury: isolated (injury of one organ), multiple, combined or associated with other injuries.

Incident scene assessment, safety and personal protection are key when working with trauma patients. Begin initial patient assessment with manual head and neck stabilizations, assess consciousness using AVPU scale, check ABCDE (breathing, breathing, circulation, incapacitation, exposure), administer oxygen (highly concentrated 100% oxygen via tank mask at a rate of 10- 15 L/min) and measure oxygen saturation. Perform a rapid trauma assessment to assess and identify life-threatening injuries, then provide appropriate care. This examination is performed from head to toe, and when turning the patient, examine the back as well. Immobilize the patient using a long spinal board, vacuum pad, or other appropriate methods.

Abdominal examination:

First, examine the abdomen, gently exposing it to check for visible injuries (open wounds, bruises, etc.). Palpate gently in the four quadrants to assess for tenderness, tenderness, distension, bleeding, and abdominal wall tension. It is important to evaluate adjacent systems, such as the chest and pelvis, even if the injury appears localized and there was no general mechanism of injury. Do not auscultate the abdomen to avoid wasting time. Abdominal injuries should not be ruled out during the initial evaluation if there is a significant mechanism of injury; this should be evaluated in the hospital after a thorough examination.


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