ABDOMINAL TRAUMA PENETRATING

See Truncal penetration

See Thoracic penetration

RESUSCITATION

Circulation

If arrested (thorocotomy/cross clamp aorta)
If unstable then consider limited resuscitation and immediate OT
Blood grouping

Other

CXR
FAST U/S (including sub-xiphoid view)
AXR (if implement in situ)
IDC
NGT

INDICATIONS FOR LAPAROTOMY

If unstable and FAST shows free fluid
Missile or implement in situ
Peritonism
Evisceration
GI bleed
CXR - bowel in thorax

OT

INVESTIGATION FOR EQUIVOCAL INJURIES

Local wound exploration

Peritoneal breech		DPL or laparoscopy or laparotomy
Equivocal		CT abdomen or DPL or laparoscopy or laparotomy
No peritoneal breech		Discharge

OTHER MANAGEMENT

Triple IV antibiotic prophylaxis

DISPOSITION

Operating theatre

All unstable or definite injuries

Admit to HDU (if not already going to theatre)

Equivocal or definite peritoneal breech

Discharge only if:

Wound exploration by experienced operator shows no peritoneal breech