An abdominal mass might be a collection of blood or fluid. The following lab work is considered basic for evaluating a victim of abdominal trauma: * Urinalysis detects blood as a sign of urinary tract injury. CHOP does not represent or warrant that the clinical pathways are in every respect accurate or complete, or that one or more of them apply to a particular patient or medical condition. Amylase 4. Prepare to use standard precautions, which are mandatory. Patients with hollow viscous injury will benefit from antibiotic therapy. Bilateral symmetric breath sounds and chest rise? o 3 = Decorticate posture (adduction of arms, flexion of elbows and wrists) is For injuries that penetrate the peritoneal cavity (penetrating abdominal trauma), prophylactic (preventative) antibiotics are often administered with the goal of reducing the risk of sepsis and septic complications, including septicaemia, abscesses in the abdomen, and wound infections. Acidosis Penetrating injuries however can result in trauma to any organ system within the abdomen and occasionally the chest depending on the trajectory of the bullet/knife. View ATI Frequently Missed Questions.docx from NURSING 4314 at University of Texas, Health Science Center at San Antonio. Yet even a serious, life-threatening abdominal injury may not cause obvious signs and symptoms, especially in cases of blunt trauma. VCA All Pets Hospital has been serving birds, cats, dogs, and exotic animals in San Francisco, California, since 1968. o Older adult clients can have arthritis, which can make lying in bed for 4 to Damage control resuscitation: directly addressing the early coagulopathy of trauma. We are working on getting an IV now. fingers and toes, carpopedal spasms, convulsions) use mild foot powder on sweaty feet Provide peritoneal lavage What nursing management would you provide to a client with abdominal trauma? Editor: Gregory J. Tudor, MD, University of IL College of Medicine - Peoria, IL. o 3 = Eye opening occurs secondary to sound The elderly have a thinner abdominal wall Video-assisted diagnostic laparoscopy has helped reduce the number of laparotomies performed to evaluate abdominal trauma. contact provider if bleeding from insertion site lasts longer than 30 min following dialysis, for no thrill/bruit, or signs of infection Findings are hyperthermia, hypertension, delirium, vomiting, abdominal pain, 3. 7. Epidural Analgesia, High spinal anesthesia The frequencies of different types of cancer in these individuals varied across the decades. Respiratory Diagnostic Procedures: Priority Intervention Following a 4. 2. Lipase and around the tracheostomy holder and plate. NG tube for aspiration mg/dL in 1 week or less. Avoid heavy lifting sports, and driving A rectal exam can alert the provider to a high riding prostate, lack of rectal tone, or heme-positive stools. What are the components of an emergency assessment for abdominal trauma? The 1960s1960s1960s and 1970s1970s1970s brought high levels of breast and salivary gland cancers. Penetrating injuries 2. The absence of bowel sounds could be an early sign of intraperitoneal damage. Because liver tissue is very friable and the liver's blood supply and storage capacity are extensive, a patient with liver injuries can hemorrhage profusely and may need surgery to control the bleeding. A bruit near the epigastric area 3. Next, perform a rapid neurologic examination and assess him head to toe to identify obvious injuries and signs of prolonged exposure to heat or cold. o 4 = General withdrawal from pain monitor electrolyte values, Tuberculosis: Client Teaching (Active Learning Template - System Disorder, RM AMS RN 10.0 Chp 23), airborne precautions are not needed in the home Monitor level of consciousness Colon. (2011). Misplacing the trocar, however, could cause an injury. 1. Blunt forces cause most bladder injuries. Once the appropriate depth of insertion is confirmed, the balloon is inflated using IV contrast solution in order to occlude aortic flow distal to the balloon. It also The vast majority (over 90%) of major trauma in Australia is caused by blunt injury mechanisms, such as those caused by motor vehicle collisions (MVC), falls, and being forcefully struck. Lipase levels can illustrate any theoretical injury to the pancreas although the evidence behind this is not substantial. Inspection The patient is ordered Morphine 2 mg IV every 4-6 hours as needed for pain. REBOA can be used to control hemorrhage in abdominal trauma, as long as there are no thoracic injuries such as aortic dissection or cardiac tamponade (i.e. Monitor for development of significant fever (mild fever for less than 24 hours is Emerg Med 2010;42(8):6-13. (See Pinpointing key injuries for more details.). Table 1. prime blood administration with 0.9% sodium chloride 6. Advances in abdominal trauma. Liver, 2. Sensory Perception: Advocating for a client who uses sign language. Although highly sensitive for bleeding, DPL doesn't indicate the source. Even when the patient is bleeding, his initial hemoglobin and hematocrit results may be normal due to volume loss and hemoconcentration. Nursing Interventions to Prevent Acute Kidney Injury. Gun shot wound What is a major cause of blunt trauma abdominal trauma? Upon completion of this module, the student will be able to: Abdominal trauma is seen quite often in the Emergency Department and can result from blunt or penetrating mechanisms. The abdominal exam should detail exit and entry wounds, number of wounds, any evisceration, ecchymosis and deformity, in addition to tenderness. 3. sputum samples are needed every 2-4 weeks to monitor therapy effectiveness Pain management If he's unstable, you may have to rely on inspection and auscultation alone. change dressings every 7 days or per hospital policy o Allow adequate time for the cough and gag reflex to return prior to Intestinal injuries, although less common, may also be present. (See "Assessing the Abdomen" in the May issue of Nursing2003 for more on assessment techniques.). What does Abdominal Compartment Syndrome cause in regards to the IVC? 13(1):61-65, March 2001. The abdominal distension is likely from a liver or small bowel injury, depending on the location and trajectory of the entrance wound. By becoming adept at identifying danger signs and changes in your patient's condition, you'll ward off potential complications and help him heal. 5. Secure the new ties before It might just come in handy on this case. Raynauds phenomenon (arteriolar vasospasm in response to cold/stress). Resuscitative Endovascular Balloon Occlusion of the Aorta and Resuscitative Thoracotomy in Select Patients with Hemorrhagic Shock: Early Results from the American Association for the Surgery of Traumas Aortic Occlusion in Resuscitation for Trauma and Acute Care Surgery Registry. 5. Practice management guidelines for the evaluation of blunt abdominal trauma: The EAST Practice Management Guidelines Work Group. 3. Hypothermia ASSESSMENT SAFETY CONSIDERATIONS Risk Factors Expected Findings laceration to the stomach or bruising, MVA, risky behaviors Laboratory Tests Diagnostic Procedures xray, ct, mri, cbc no dx needed PATIENT-CENTERED CARE Nursing Care iv access, pain mgmt, catheter, ng tube, minimize leakage of contents prevent infection Therapeutic Procedures surgery Blood A rectal examination can help pinpoint injury to the urinary tract or pelvis. Trauma Reports 2012;13 (4): 1-12. What discharge planning should you complete for a client with abdominal trauma? wear clean, absorbent socks that are made of cotton or woll Polycystic Kidney Disease, Acute Kidney Injury, and Chronic Kidney Disease: What will you monitor when completing a serial assessment of lab data for a client with abdominal trauma? appetite, or malaise. (continued elevation can indicate pancreatic abscess or pseudocyst). Connect with us on Facebook, Twitter, Linkedin, YouTube, Pinterest, and Instagram. Assess for bleeding He'll assess the abdomen and pelvis, then base the surgical interventions on the extent of injury, the organ involved, and the patient's other injuries, clinical condition, age, and comorbid conditions. manipulation of the gland during surgery. Start by taking an AMPLE history (Allergies, Medications, Past Medical History, Last Oral Intake and Events Preceding the Incident). Lipase. nausea) and neurotoxicity (such as tingling of the hands and feet), Rifampin: Swelling of joints, loss of appetite jaundice, or malaise. How long is a client hospitalized for observation after sustaining a blunt trauma injury? * Insert a gastric tube to decompress the patient's stomach, prevent aspiration, and minimize leakage of gastric contents and contamination of the abdominal cavity. What special considerations need to be taken into consideration with abdominal trauma and children? The liver can commonly be crushed. If someone has a gun shot wound, what will you count? * Insert an indwelling urinary catheter, unless you suspect a urinary tract injury. Blunt abdominal trauma may lead to diaphragmatic rupture, most commonly on the patients left side. If the patient was in an MVC, look for a contusion or abrasion across his lower abdomen, known as the "seat belt sign." A: airway: open airway with head tilt/chin lift maneuver Details of the abdominal trauma mechanism are helpful. Blow to the stomach (like a punch) 2010. return. Yann Wehrling, vice-prsident de la rgion le-de-France, charg de la Transition cologique, et Patrice Leclerc, maire de Gennevilliers et Prsident du groupe Front De Gauche la . Assume that one equivalent of HBr is eliminated in each case. tachydysrhythmias, chest pain, dyspnea, and palpitations. procedures. pain, tachydysrhythmias, chest pain, dyspnea, and palpitations. A 55-year-old female arrives to the ER with a right leg fracture. SWs are more common than GSWs, however they have a lower mortality rate compared with GSWs. Melana Cover the exposed viscera with a sterile dressing. What is your concern if a client is stabbed in a solid organ? Of note, occult cervical spine injury is unlikely in patients with penetrating trauma. MVA Consume four to six small meals throughout the day. lipase increases slowly and can remain increased for days longer than amylase For example, a victim of an MVC can sustain a lap belt injury that deserves special attention. The abdominal space in the anterior portion of the abdomen. The clinical pathways are based upon publicly available medical evidence and/or a consensus of medical practitioners at The Childrens Hospital of Philadelphia (CHOP) and are current at the time of publication. pdf, (8) Making freebase with ammonia cracksmokers, Leadership class , week 3 executive summary, I am doing my essay on the Ted Talk titaled How One Photo Captured a Humanitie Crisis https, School-Plan - School Plan of San Juan Integrated School, SEC-502-RS-Dispositions Self-Assessment Survey T3 (1), Techniques DE Separation ET Analyse EN Biochimi 1. Abdominal Trauma presentations are complex because they can present with poly-trauma resulting in imminently life-threatening injuries, distracting injuries and altered mental status. The convection heat transfer coefficient on the fuel rod is 5000W/m2K,5000 \mathrm{W} / \mathrm{m}^{2} \cdot \mathrm{K},5000W/m2K, and the average temperature of the cooling water, sufficiently far from the fuel rod, is 70C.70^{\circ} \mathrm{C}.70C. Hoff W, et al. We understand and share your compassion for animals, and it is our goal to provide the highest . Avoid neck extension. Pelvic fracture is another common injury seen in blunt abdominal trauma. Identify the residents at greatest risk for development of pressure ulcers. The REBOA device is inserted using the Seldinger technique under ultrasound guidance into the femoral artery. be administered. Neurologic Diagnostic Procedures: Determining a Glasgow Come Scale Score, Eye opening (E): The best eye response, with responses ranging from 4 to 1 Ask the patient (or his family, emergency personnel, or bystanders) about his history-allergies, medications, preexisting medical conditions, when he last ate, and events immediately preceding or related to his injury. These patients typically have isolated blunt abdominal trauma and a minor mechanism of injury, normal sensorium, and no tenderness or peritoneal signs; they should be instructed to return immediately if pain worsens. and level of consciousness during the recovery period. What can occur if the bladder is too full? Talking About What Happened With Others 24:B:30a, A Teen's Story - Facing My Friends and Fears After Injury 24:B:31b, A Teen's Story - Putting My Life Back Together 24:B:31c. * Prothrombin time, international normalized ratio, and activated partial thromboplastin time screen for coagulopathy. Healthcare Strategic Management and Policy (HCM415), Curriculum Instruction and Assessment (D171), Professional Application in Service Learning I (LDR-461), Advanced Anatomy & Physiology for Health Professions (NUR 4904), Principles Of Environmental Science (ENV 100), Operating Systems 2 (proctored course) (CS 3307), Comparative Programming Languages (CS 4402), Business Core Capstone: An Integrated Application (D083), Lesson 9 Seismic Waves; Locating Earthquakes, Exam View - Chapter 09 - Seidals Guide To Physical Examination 9Th Edition, Peds Exam 1 - Professor Lewis, Pediatric Exam 1 Notes, A&P II Chapter 21 Circulatory System, Blood Vessels, (Ybaez, Alcy B.) Many abdominal injuries are due to falling and the women's loss of balance associated with the weight gained from the baby. Yakobi, R. et al. the client has COPD, insert a 2L/min nasal cannula and increase the oxygen flow - WBC count: increased due to infection and inflammation Use a new inner cannula if it is disposable. What will increased velocity of trauma cause? What will you monitor the client for who has had abdominal trauma? In gunshot wounds, the type of gun, distance from the shooter, and number of shots heard are all relevant. Voldyne. antiplatelet medication such as tricagrelor, prasugrel, or cangrelor can Initial Actions and Primary Survey Abdominal trauma can present in multiple ways. Where is the retroperitoneal compartment? Reduction of Risk Potential can occur following a surgical procedure or a thyroidectomy as a result of Wound management. Patients without identifiable injuries who have a benign physical exam may be discharged home with explicit instructions regarding signs and symptoms that should prompt their return or re-evaluation. Abdominal pain ascending and descending. Fractures of ribs 10 to 12 on the left should raise your suspicion of spleen damage, which ranges from laceration of the capsule or a nonexpanding hematoma to ruptured subcapsular hematomas or parenchymal laceration. While you wait for the patient to arrive, don a fluid-impervious gown, gloves, and face and eye protection, such as a face shield or goggles and mask, in case blood splashes. Atropine Sulfate. The medical team can use diagnostic test results to grade the patient's injuries according to several classification systems, then target treatments to specific organs, evaluate the patient's responses, and monitor him for complications. blunt trauma. Look for and document obvious abnormalities, including distension, contusions, abrasions, lacerations, penetrating wounds, and asymmetry. Please check out also our reviewer for emergency nursing below. and digitalis toxicity, all of which increase demands on body metabolism. o Leased to depressed respirations, respiratory arrest, and severe As the nurse you know it is priority to: * A. obtain signed informed consent for the second unit of blood from the patient B. obtain a new y-tubing set for this unit of blood C. type and crossmatch the patient D. hang a new bag of dextrose to transfuse with the blood 15. - Serum glucose: increased due to a decrease in insulin production by the Avoid any palpation of abdominal mass; post sign on bed stating not to palpate preoperatively; assess incision site for redness, swelling, drainage, intactness, and healing and change dressing when soiled or wet; assess oral and perineal area; and encourage parents to appropriately dress child based on weather conditions and to refrain from Tuberculosis: Adverse Effects of Antimicrobial Therapy, Isoniazid: Monitor for hepatotoxicity (jaundice, anorexia, malaise, fatigue, and Penetrating injuries are easier to detect. Back: signs of penetration. ABGs Areas of purple discoloration should make you suspicious. American College of Surgeons; 2013. Copyright 2023 StudeerSnel B.V., Keizersgracht 424, 1016 GC Amsterdam, KVK: 56829787, BTW: NL852321363B01, Give Me Liberty! avoid using the back of client's hand In New York Handbook of Emergency Medicine. Airway Management: Evaluating Client Understanding of Tracheostomy Care Author: Nur-Ain Nadir. - Blood creatinine gradually increases 1 t0 2 mg/dL every 24 to 48 hr, or 1 to 6 * Control the patient's pain without sedating him, so you can continue to assess his injuries and ask him questions. Nursing Management. formation and restenosis. Blunt abdominal trauma (BAT) is frequently encountered in the form of motor vehicle crashes (MVCs) (75%), followed by falls and direct abdominal impact. Continuous abdominal assessment You also know that your trauma surgical team just took a GSW to the OR in the last hour. Educate on signs and symptoms of bleeding The patient must be hemodynamically stable and cooperative so he can be moved from the ED and lie quietly for the test. Retroperitoneal organs and the vasculature can also be easily visualized with CT Scans. Figure 3: Positive FAST image of LUQ courtesy of David Bahner MD, RDMS Associate Professor of Emergency Medicine, The Ohio State University Department of Emergency Medicine. 1. Send the client for a CAT scan * Serum amylase and lipase levels, when persistently elevated, may indicate injury to the pancreas or bowel. Place the client on high-flow oxygen, such as 100% non-rebreather face mask. stay with client first 15-30 min during infusion; assess vital signs, Cardiovascular Diagnostic and Therapeutic Procedures: Caring for a Client Who Has a Peripherally Inserted Central Catheter (Active Learning Template - Therapeutic Procedure, RM AMS RN 10.0 Chp 27), confirm placement of PICC with xray 2. 10. o Auscultate lung sounds Blunt abdominal traumatic injuries are notoriously more difficult to detect, and patients may present without specific abdominal tenderness or are distracted due to other injuries. (August). There is no place for ED thoracotomy for blunt thoracoabdominal injuries. The abdominal assessment is often less than effective due to the often subtle signs and symptoms and the other distracting injuries a patient may have. 6. (2007). Severe left shoulder pain; indicates trauma of the spleen. Free fluid in Morrisons pouch is concerning for hemoperitoneum, which may require emergent surgical intervention (See Figure 3). 4. If rash and dysgeusia (altered taste) occur inform provider immediately. (b) Describe the hybridization of the Batoms in the molecule and the geometry around each Batom. o Clopidogrel (if having percutaneous coronary intervention, other Hemorrhage. Deceleration forces may damage the renal artery; collateral circulation in that area is limited, so any ischemia is serious and may trigger acute tubular necrosis. [Show more] Preview 3 out of 21 pages Abdominal Trauma General DRG Category: 326 Mean LOS: 14.0 days Description SURGICAL: Stomach, Esophageal, and Duodenal Procedure With Major CC DRG Category: 394 Mean LOS: 4.1 days Description MEDICAL: Other Digestive System Diagnoses With CC Classification Section Nursing Type Primary: trauma care Nursing Type Secondary: acute care Emergency Nursing Principles and Management: Priority Action for Abdominal Trauma. Sign in, Spring 2007, Volume :37 Number 4 - Supplement: ED Insider , page 4 - 11 [Free], Join NursingCenter to get uninterrupted access to this Article. Skin appearance: cold & clammy or warm & well perfused? Today's technology helps pinpoint the location, nature, and severity of abdominal injuries. Revent hypothermia 3. 2. to maximize ventilation (high-Fowlers = 90). Next, perform a rapid neurologic examination and assess him head to toe to identify obvious injuries and signs of prolonged exposure to heat or cold. 2023 Wolters Kluwer Health, Inc. and/or its subsidiaries. Three Critical Points for Remediation Bronchoscopy What labs would you monitor for a client with abdominal trauma? Ethambutol: vision changes The best way to document your patient's lab values is on a flow sheet. non-pharmacological treatments for phantom pain: massage, heat, TENS, ultrasound therapy, biofeedback, or relaxation therapy An inside view of trauma reviews what each technique involves. Ecchymosis around the umbilicus (Cullen's sign) or flanks (Grey-Turner's sign) may indicate retroperitoneal hemorrhage, but these signs may not appear for hours or days. clients receiving local anesthesia due to impaired laryngeal reflex. On what side of the body do knife wounds most often occur? (Appropriate tests are listed later in this article.). Supervise residents to ensure adequate nutritional intake A B. The higher energy transfer and missile trajectory with multiple bullet fragments from GSWs leads to increased morbidity and mortality compared to stab wounds. Bowel sounds in the chest may signal a ruptured diaphragm with herniation of the small bowel into the thoracic cavity. Consume foods high in protein and fiber, Head Injury: Responding to Change in Level of Consciousness (Active Learning Template - System Disorder, RM AMS RN 10.0 Chp 14), Maintain low stimulation environment - Maintain bed rest in supine position with extremity straight for prescribed time. apply skin barriers and creams to peristomal skin and allow to dry before applying a new appliance, Hemodialysis and Peritoneal Dialysis: Planning Care for a Client Who Has an Arteriovenous Graft (Active Learning Template - Therapeutic Procedure, RM AMS RN 10.0 Chp 57, check assess site at intervals following dialysis The following findings are abnormal: * Pain with light percussion suggests peritoneal inflammation. There are two main kinds of PAT: Stab Wounds (SW) and Gun Shot Wounds (GSW). Prevent/treat infection or sandbags. eventually fluids. Stand or sit facing clients in a well-lit, quiet room without distractions, Speak clearly and slowly without shouting and without hands or other objects Deceleration with shearing may tear the small bowel, generally in relatively fixed or looped areas. wrists) is present. 1. CBC A bruit near the epigastric area Correct - A bruit in the aortic area signals the presence of an . Flank. The priority action is to confirm the serum glucose before proceeding. Assess for edema and manifestations of heart failure or pulmonary edema. How would you change the recipe to make sure you have enough? 4. The following interventions are routine for a patient with abdominal trauma: * Insert two large-bore intravenous (I.V.) False negatives are possible if the patient has adhesions or retroperitoneal hemorrhage. An initially negative eFAST exam, should be repeated if the clinical picture changes during evaluation. Keep in mind that these signs and symptoms might not be present if he has competing pain from another injury, a retroperitoneal hematoma, spinal cord injury, or decreased level of consciousness or if he's under the influence of drugs or alcohol. small amount of blood-tinged sputum is expected), and hypoxemia. with Graves disease, infection, trauma, emotional stress, diabetic ketoacidosis, pancreas. Abdominal cavity removing the soiled ones to prevent accidental decannulation Before you percuss and palpate your patient's abdomen, ask him to point to painful areas and be sure to examine them last. (tachycardia, diaphoresis, nervousness) Bedside sonography is increasingly useful for diagnosis of hemoperitoneum in BAT. 5. Emergency Medicine. o Assess level of consciousness while recognizing that older adult clients Wear sturdy shoes if pregnant Hidden in the abdomen, life-threatening injuries can elude detection. You hear the sirens getting louder as the ambulance carrying your trauma patient pulls into the ED parking lot and recall that a stab wound is most likely to injure: 1. ATI comprehensive predictor with 197 Questions and Answers 2023 NEW ATI comprehensive predictor/ 197 Questions and answers/100% Correct A nurse on a med surge unit has recieved change of shift report and will care for 4 clients. (The molecule has a B-B covalent bond.). 2. - Blood urea nitrogen (BUN) can increase 80 to 100 mg/dL within 1 week intraoperatively (perioral or extremity tingling, muscle twitching for positive Following the primary survey, the secondary survey must be performed. hypotension Blunt injuries suffered during an MVC can be especially difficult to detect. Clinical policy: Critical issues in the evaluation of adult patients presenting to the emergency department with acute blunt abdominal trauma. Blood should be transfused as needed, keeping in mind principles of permissive hypotension. These factors include altered mental status, intoxication and distracting injuries. You are in the middle of your shift and overhear an EMS call regarding a trauma patient coming in with lights and sirens: Onboard we have a 23 year-old male, stabbing victim with a single stab wound to the abdomen, multiple abrasions, contusions and lacerations to the extremities. Open airway with head tilt/chin lift maneuver. 2. What will you use on the client who has had aspiration? - Assess level of consciousness, presence of gag reflex, and ability to swallow resuming oral intake. If your patient sustained blunt trauma, as in a motor vehicle crash (MVC), keep his neck and spine immobilized until X-rays rule out a spinal injury. approved solution). : chest exam is normal, chest Xray shows no hemothorax, and eFAST shows no blood in the pericardium). Clinical Assessment As with all trauma management, the priority is to identify immediately life-threatening injuries. check for patency by checking for a thrill or bruit, Airway Management: Evaluating Client Understanding of Tracheostomy Care (Active Learning Template - Therapeutic Procedure, RM FUND 9.0 Ch 53), wash hands thoroughly, need one person to hold tube in place and one person to change ties when soiled, clean inner cannula with normal saline and with 4x4 mesh pad, inspect skin, wash hands again, Asthma: Using a Peak Flow Meter (Active Learning Template - Diagnostic Procedure, RM NCC RN 10.0 Chp 18), zero the scale, stand up or sit straight, take a deep breath and fill lungs all the way, exhale as hard and fast as you can, write down number, wait a minute, repeat, record the highest out of the 3 tries, do this at the same time every day, Gastrointestinal Therapeutic Procedures: Interventions for Dumping Syndrome (Active Learning Template - System Disorder, RM AMS RN 10.0 Chp 47), eat more frequent smaller meals throughout day When assessing a trauma victim, it is important to be aware of factors that make a physical exam unreliable. Knepel S, Kman N, ORourke K, Hays HL. Emergency Department, Inpatient, and ICU Clinical Pathway for Children with Blunt Abdominal Solid Organ Injury Patient Education Instructions for Home Management - Abdominal Trauma: Non-Operative Management 24:B:04 After the Injury: Helping My Child Cope - Things Parents Can Do and Say 24:B:23a Penetrating injuries include gunshot and shrapnel injuries, impalements, and knifings. A cylindrical fuel rod of 2 cm in diameter is encased in a concentric tube and cooled by water. 5. instruct client to hold his arms below level of heart 2. The clinician inserts a tiny camera through a small incision in the abdomen to evaluate the organs. Generate a differential diagnosis of potential traumatic injuries based on history, mechanism, and physical exam. Appreciate the necessity for emergent surgical intervention in certain abdominal trauma conditions, GSW penetrating trauma has a much higher morbidity and mortality compared with SW trauma, Although blunt thoracoabdominal trauma patients are no longer candidates for ED thoracotomies, select penetrating thoracoabdominal trauma patients are candidates for ED thoracotomies, Effective Consultation in Emergency Medicine Video, Virtual Rotation and Educational Resources, Committee Update: NBME EM Advanced Clinical Examination Task Force. 2 demonstrates a negative RUQ eFAST exam. Lupus Erythematosus, Gout, and Fibromyalgia: Evaluating Client Teaching (Active Learning Template - System Disorder, RM AMS RN 10.0 Chp 87), SLE: provide small, frequent meals if anorexia is concern, encourage limit of salt intake for fluid retention, avoid UV and prolonged sun exposure, use mild protein shampoo and avoid harsh hair treatments, avoid crowds and people who are sick Potential for sustaining abdominal trauma. Discuss the eventual disposition of abdominal trauma patients based on their diagnosis. - Hypocalcemia and tetany.