BLUNT ABDOMINAL TRAUMASURGICAL ABDOMEN*TO O.R. FOR
EX-LAPYESHEMODYNAMIC ASSESSMENTNODPL**or
ULTRASOUNDUNSTABLE(-)SEARCHFOR OTHER SOURCES OF BLEEDING*CXRPELVIS
X-RAY / RETROPERITONEUMLACERATIONS /
FRACTURES(+)FASTULTRASOUNDSTABLESERIAL EXAMSD/C AFTER 12-24 HR(-)CT
SCAN(+)FREEFLUID ONLYSERIAL EXAMSSERIAL HCT'SWBC'S, ABG'SREPEAT CT
/ USPANCREATIC INJURY orINTRAPERITONEAL FREE AIRTO O.R.
FOREX-LAPSOLID ORGAN INJURY( LIVER, SPLEEN, KIDNEY
)CONTRASTEXTRAVASATIONNON-OPMANAGEMENTPROTOCOLNOGRADE IV - V(
LIVER, KIDNEY )CONSIDER ANGIO FOR EMBOLIZATION IFCONTINUED
STABLEFAILURETO O.R. FOR EX-LAPSPLEEN KIDNEY LIVERREMOVEREPAIR
GRADE I - IIIREPAIRGRADE IV - VREPAIRPACKINGANGIOGRADE I -
IIIREPAIRGRADE IV - VUROLOGYCONSULTFor evidence based medicine
literature reference list: Hoff, WS, Holevar M, Nagy KK, et. al.
Practice Management Guidelines for the Evaluation of Blunt
Abdominal Trauma: The EAST PracticeManagement Guidelines Work
Group. JTrauma. 2002;53, 602-614*Hemodynamic instability**Positive
criteria for DPL in blunt trauma: >100,000 RBC/mm3 , >500 WBC
mm3 or bowel contentRevised 6/4/04(+)2001
