Greg, thank you for giving us personal instruction on this situation last night
and for taking the time to document this information.
I really appreciate the firsthand and valuable knowledge you share through
Sent from my iPhone
On Jan 12, 2019, at 11:29 PM, gckerwin <gckerwin@xxxxxxxxx> wrote:
Last week a pediatric abdominal trauma was managed well by the patrol
managing. A diagnosis (as reported on social media) was a liver laceration.
This issue can be life threatening. I was asked to review the case and I
thought I would share the abdominal assessment with you.
1 MOI: the MOI for abdominal trauma is not necessarily direct impact or
penetration to the abdomen. Any trauma with energy traversing the abdomen can
cause an injury. My favorite example of this principle is a 6 year old girl
at a local elementary school coming off the slide appropriately and landing
on her butt. Typically this is how the slide is designed to be used. In her
case the energy traveled up from her buttocks into her abdomen causing a
grade II splenic laceration.
2. any post trauma (even minor trauma) the abdomen should be assessed.
3. any complaint of abdominal pain should be directed to the emergency
4. An increase in pain with palpation over 1 of the 4 quadrants of the
abdomen should be considered an organ injury and handled by EMS activation.
5. Rebound tenderness or + Kehr's sign (pain radiating to the left shoulder)
should be an indication of active bleeding into the abdominal cavity
See the graphic display of this decision tree.
Please let me know if you have question or would like to do a hands on