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Blunt Abdominal Injury


For patients with blunt trauma only



Inclusion Criteria

  • Cooperative patient with stable vital signs (RR>8 or <24, SBP>100, P>60 or <110)
  • No Peritoneal Signs
  • Negative initial imaging studies (i.e. CT)
  • Pertinent lab results acceptable (e.g., Hgb)
  • Surgery consult documented

Exclusion Criteria

  • Uncooperative patient, patients requiring restraints
  • Impending alcohol withdrawal syndrome
  • ETOH estimated >200 mg/dL at transfer
  • Pregnancy >20 weeks
  • Abnormal vital signs (above)
  • CT scan not done or significant acute abnormality

Potential Interventions

  • NPO initially, advance per physician
  • Repeat Hct q 4-6 hours (if pertinent to patient’s management)
  • Serial abdominal examinations (e.g. q 4 hours)
  • If indicated by physician, serial ultrasounds
  • Immediate reevaluation by ED physician or surgeon if patient develops:
    • Significant vomiting
    • Increasing abdominal pain
    • Increased tenderness on serial abdominal exams
    • Worsening vital signs: Decreased BP, increased HR, fever

Discharge Criteria

Home

    • Patient is ambulatory
    • Serial abdominal exams essentially negative
    • Repeat labs reviewed and stable(Specifically any Hb drop?)
    • Vital signs reviewed and stable
    • Patient able to tolerate PO
    • Appropriate follow-up established
    • Surgery agrees with disposition


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