5 Questions
What is the recommended management for hemodynamically unstable trauma patients with a positive FAST?
Immediate exploratory laparotomy
What imaging modality is available at Role 3 facilities to assist in decision making for blunt abdominal trauma?
CT scan
What is the recommended management for grade IV-V splenic injuries?
Splenectomy
What is the recommended management for stable grade III splenic injuries without active extravasation, pseudo aneurysm, hemoperitoneum on CT scan or other indications for laparotomy?
Non-operative management
What should be done for patients with a positive FAST and/or evidence of hemoperitoneum through CT at a surgical facility?
Immediate exploratory laparotomy
Study Notes
- Blunt Abdominal Trauma (BAT) is a diagnostic and clinical challenge.
- CT scans are available at Role 3 facilities to assist in decision making.
- Providers at far forward surgical units must rely on physical assessment and FAST exam.
- Hemodynamically unstable trauma patients with a positive FAST should undergo exploratory laparotomy immediately.
- Patients with positive FAST and/or CT scan may be managed non-operatively if at a Role 3 facility with adequate clinical follow-up.
- Patients with a positive FAST and/or evidence of hemoperitoneum through CT at a surgical facility should not be transferred until ongoing intra-abdominal hemorrhage is controlled.
- Splenic injury grading is presented in Table 1.
- All grade IV-V splenic injuries should undergo splenectomy.
- Non-operative management may be attempted for stable grade III splenic injuries without active extravasation, pseudo aneurysm, hemoperitoneum on CT scan or other indications for laparotomy.
- In Role 3 facilities with interventional radiology capabilities, embolization of grade III splenic injuries may be considered as an adjunct to non-operative management.
Test your knowledge on the management of blunt abdominal trauma with this informative quiz. Brush up on the latest guidelines, including the use of CT scans, physical assessment, and FAST exams. Learn when to perform exploratory laparotomy, when to consider non-operative management, and when to utilize interventional radiology. Don't miss out on key information regarding splenic injury grading and when splenectomy is necessary. Take the quiz now to challenge yourself and refine your skills.
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