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Referencing the content of EMT-Basic training and emergency patient care

EMT Basic · Chapter 31

Abdominal and Genitourinary Injuries

Learning objectives (15)

  1. Define closed abdominal injuries; provide ex- amples of the mechanisms of injury (MOIs) likely to cause this type of trauma, and com- mon signs and symptoms exhibited by pa- tients — Knowledge/skills objective (printed page 1117); confirm wording in your course copy.
  2. Define open abdominal injuries; include the three common velocity levels that distinguish these injuries, provide examples of the MOIs that would cause each, and describe common si — Knowledge/skills objective (printed page 1117); confirm wording in your course copy.
  3. Demonstrate how to apply a dressing to an abdominal evisceration wound — Knowledge/skills objective (printed page 1118); confirm wording in your course copy.
  4. Demonstrate proper emergency medical care of a patient who has a penetrating abdominal injury with an impaled object — Knowledge/skills objective (printed page 1118); confirm wording in your course copy.
  5. Demonstrate proper emergency medical care of a patient who has experienced a blunt abdominal injury — Knowledge/skills objective (printed page 1118); confirm wording in your course copy.
  6. Describe some special considerations related to the care of pediatric patients and geriatric patients who have experienced abdominal trauma — Knowledge/skills objective (printed page 1117); confirm wording in your course copy.
  7. Describe the anatomy and physiology of the abdomen; include an explanation of abdominal quadrants and boundaries and the difference be- tween hollow and solid organs — Knowledge/skills objective (printed page 1117); confirm wording in your course copy.
  8. Describe the anatomy and physiology of the fe- male and male genitourinary systems; include the differences between the hollow and solid organs — Knowledge/skills objective (printed page 1118); confirm wording in your course copy.
  9. Describe the different ways hollow and solid organs of the abdomen can be injured, and include the common signs and symptoms ex- hibited by patients depending on the organ or organ — Knowledge/skills objective (printed page 1117); confirm wording in your course copy.
  10. Discuss the types of traumatic injuries sus- tained by the male and female genitouri- nary systems, including the kidneys, urinary bladder, and internal and external genitalia — Knowledge/skills objective (printed page 1118); confirm wording in your course copy.
  11. Explain assessment of a patient who has ex- perienced a genitourinary injury; include special considerations related to patient privacy and determining the MOI — Knowledge/skills objective (printed page 1118); confirm wording in your course copy.
  12. Explain assessment of a patient who has ex- perienced an abdominal injury; include com- mon indicators that help determine the MOI and whether it is a significant MOI — Knowledge/skills objective (printed page 1117); confirm wording in your course copy.
  13. Explain special considerations related to a patient who has experienced a genitourinary injury caused by a sexual assault, including patient treatment, criminal implications, and e — Knowledge/skills objective (printed page 1118); confirm wording in your course copy.
  14. Explain the emergency medical care of a pa- tient who has sustained a closed abdominal injury, including blunt trauma caused by a seat belt or airbag — Knowledge/skills objective (printed page 1117); confirm wording in your course copy.
  15. Explain the emergency medical care of a patient who has sustained a genitourinary in- jury to the kidneys, urinary bladder, external male genitalia, female genitalia, or rectum — Knowledge/skills objective (printed page 1118); confirm wording in your course copy.

Vocabulary (11)

Peritoneum
The thin membrane lining the abdominal cavity and covering most abdominal organs.
Solid organ injury
Damage to a dense, blood-rich organ — liver, spleen, kidney, pancreas — typically presenting with internal bleeding and shock.
Hollow organ injury
Damage to a tube-like organ — stomach, bowel, bladder — that may spill contents into the abdomen and cause peritonitis.
Evisceration
Protrusion of internal organs through an open abdominal wound.
Kehr's sign
Referred left shoulder pain caused by diaphragmatic irritation from splenic injury or hemoperitoneum.
Cullen's sign
Periumbilical bruising suggesting retroperitoneal hemorrhage or pancreatitis.
Grey-Turner's sign
Flank bruising indicating retroperitoneal hemorrhage.
Seat-belt sign
A band of bruising across the abdomen following a vehicle collision; raises suspicion for bowel, mesenteric, or vertebral injury.
Renal contusion
Bruising of the kidney from blunt trauma, often presenting with flank pain and hematuria.
Pelvic fracture
A break in one or more bones of the pelvic ring; high-energy fractures can produce massive internal bleeding and instability.
FAST exam
Focused Assessment with Sonography for Trauma — bedside ultrasound performed at the hospital to detect free fluid in the abdomen and pericardium.

Sequence practice (2 puzzles on Quiz Me)

Field care of an evisceration

Order EMT steps for an abdominal evisceration.

  1. Do not attempt to replace organs back inside the abdomen
  2. Cover protruding organs with a moist sterile dressing
  3. Cover the moist dressing with an occlusive layer to retain moisture and warmth
  4. Keep the patient warm and position with knees flexed if comfortable
  5. Rapid transport to a trauma center
Abdominal trauma assessment in the field

Order the EMT's exam sequence in suspected abdominal trauma.

  1. Inspect — bruising, distension, evisceration, seat-belt sign
  2. Auscultate if part of your level's exam
  3. Palpate gently, starting away from the painful area
  4. Note guarding, rigidity, rebound, masses
  5. Look for referred-pain signs (Kehr's, Cullen's, Grey-Turner's)
  6. High index of suspicion → trauma center transport

Quick fire sample (11 of 11 on Quiz Me)

The thin membrane lining the abdominal cavity and covering most abdominal organs.
  1. Seat-belt sign
  2. Renal contusion
  3. Peritoneum
  4. FAST exam
Damage to a dense, blood-rich organ — liver, spleen, kidney, pancreas — typically presenting with internal bleeding and shock.
  1. Peritoneum
  2. Evisceration
  3. Solid organ injury
  4. Cullen's sign
Damage to a tube-like organ — stomach, bowel, bladder — that may spill contents into the abdomen and cause peritonitis.
  1. Hollow organ injury
  2. Solid organ injury
  3. Kehr's sign
  4. Pelvic fracture
Protrusion of internal organs through an open abdominal wound.
  1. Hollow organ injury
  2. Renal contusion
  3. Evisceration
  4. Solid organ injury
Referred left shoulder pain caused by diaphragmatic irritation from splenic injury or hemoperitoneum.
  1. Cullen's sign
  2. FAST exam
  3. Peritoneum
  4. Kehr's sign
Periumbilical bruising suggesting retroperitoneal hemorrhage or pancreatitis.
  1. Renal contusion
  2. Solid organ injury
  3. Cullen's sign
  4. Evisceration
Flank bruising indicating retroperitoneal hemorrhage.
  1. Hollow organ injury
  2. Cullen's sign
  3. Grey-Turner's sign
  4. Peritoneum
A band of bruising across the abdomen following a vehicle collision; raises suspicion for bowel, mesenteric, or vertebral injury.
  1. Seat-belt sign
  2. FAST exam
  3. Peritoneum
  4. Renal contusion
Bruising of the kidney from blunt trauma, often presenting with flank pain and hematuria.
  1. Pelvic fracture
  2. Cullen's sign
  3. Renal contusion
  4. Solid organ injury
A break in one or more bones of the pelvic ring; high-energy fractures can produce massive internal bleeding and instability.
  1. Pelvic fracture
  2. Cullen's sign
  3. Hollow organ injury
  4. Kehr's sign
Focused Assessment with Sonography for Trauma — bedside ultrasound performed at the hospital to detect free fluid in the abdomen and pericardium.
  1. FAST exam
  2. Cullen's sign
  3. Hollow organ injury
  4. Evisceration

Some topics in this course differ across field references. See when sources disagree on Quiz Me before you teach from this sheet alone.

Full scored drills are on Quiz Me at /courses/nm-emt-b/chapters/31/print/. Answers are not marked on this sheet.