- Prehospital Trauma Life Support Abdominal and Pelvic Trauma Flashcards

Which organ is the most commonly injured solid organ in blunt abdominal trauma?

Answer: Spleen

The spleen is the most commonly injured solid organ in blunt abdominal trauma due to its location, vascularity, and relatively fragile capsule.

What is the primary prehospital concern with penetrating abdominal trauma?

Answer: Internal hemorrhage and hollow organ injury

Penetrating abdominal trauma can cause significant internal hemorrhage from solid organ or vascular injury and peritonitis from hollow organ perforation.

How should eviscerated abdominal organs be managed in the prehospital setting?

Answer: Cover with moist sterile dressings and protect from further injury

Eviscerated organs should be covered with moist sterile dressings moistened with saline to prevent drying and contamination.

A patient involved in a motorcycle crash complains of left flank pain and has signs of shock. Which injury should be suspected?

Answer: Splenic laceration with hemorrhage

Left flank pain with signs of shock after blunt trauma strongly suggests splenic injury with significant hemorrhage.

What is the significance of pelvic instability found during physical assessment of a trauma patient?

Answer: It suggests potential life-threatening pelvic hemorrhage

Pelvic instability suggests a significant pelvic fracture with high risk of life-threatening hemorrhage from the rich pelvic vascular network.

Which of the following findings during abdominal assessment is most suggestive of peritoneal irritation?

Answer: Involuntary guarding and rigidity

Involuntary guarding and rigidity indicate peritoneal irritation, often from blood or intestinal contents irritating the peritoneal lining.

In PHTLS, what is the recommended prehospital assessment approach for suspected intra-abdominal hemorrhage?

Answer: Serial abdominal assessments combined with monitoring for signs of shock

Since prehospital providers cannot definitively diagnose intra-abdominal hemorrhage, serial assessments monitoring for worsening tenderness, distension, and shock signs guide management.

A restrained driver in a frontal collision presents with a seatbelt sign across the lower abdomen. What injuries should be suspected?

Answer: Lumbar spine fracture, mesenteric tear, and hollow organ injury

The seatbelt sign is associated with a triad of injuries: lumbar spine fractures (Chance fractures), mesenteric tears, and hollow organ perforation.

What is the role of the FAST exam in relation to PHTLS prehospital assessment?

Answer: It can supplement clinical assessment when available but does not change prehospital transport decisions for unstable patients

While FAST ultrasound can detect free fluid in the abdomen, hemodynamically unstable trauma patients still require rapid transport regardless of FAST results.

How does PHTLS recommend managing a patient with suspected bladder rupture following blunt pelvic trauma?

Answer: Monitor for signs of peritonitis and shock, apply pelvic binder, and transport rapidly

Prehospital management focuses on treating associated pelvic fracture hemorrhage with a pelvic binder, monitoring for peritonitis and shock, and rapid transport.

Which physical finding in a trauma patient suggests retroperitoneal hemorrhage?

Answer: Grey Turner's sign, flank ecchymosis

Grey Turner's sign (ecchymosis of the flanks) suggests retroperitoneal hemorrhage, though it typically takes hours to develop.

A trauma patient presents with abdominal distension, tachycardia, and dropping blood pressure 20 minutes after a stabbing. What is the most likely cause?

Answer: Intraperitoneal hemorrhage from injured abdominal vessels or organs

Progressive abdominal distension with hemodynamic instability after penetrating trauma indicates active intraperitoneal hemorrhage.