Chapter 35

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You are assessing a young male patient who was assaulted with a baseball bat and struck once on the left upper quadrant of the abdomen. You would recognize the patient as having​ Kehr's sign when he makes what​ statement?

"My left shoulder is killing​ me!"

You have been called for a​ 42-year-old male complaining of back pain. On​ scene, the man tells you that he was lying on the floor when his​ 5-year-old son unexpectedly jumped feet first onto his back. He gives a medical history of high blood pressure and​ asthma, for which he takes medications. As you assess the​ patient, which one of the following signs or symptoms provides the greatest indication that the patient has sustained an abdominal​ injury?

Blood in his urine.

If the patient has sustained an abdominal evisceration the EMT​ should:

Cover the wound with a moist dressing followed by an occlusive dressing.

If the abdomen appears larger than​ normal, this is​ called:

Distension.

You have a patient who was trapped beneath a truck along the freeway when he was trying to repair the brakes. By the time you​ arrive, the local fire department has already extricated the patient from underneath the​ truck, and he is currently immobilized. They advise you that the patient has a crushed​ pelvis, an open fracture to the left​ femur, a distended​ abdomen, and vomit in the airway. The patient suddenly became unresponsive when the weight of the truck was lifted from him. What should be your FIRST priority of​ management?

Establish an open airway.

You have arrived on the scene of a stabbing. As you approach the​ patient, you note that he has removed his shirt and has a single stab wound to the right lower quadrant of the abdomen. At the​ patient's side, your first action should be​ to:

Examine the​ patient's airway.

On​ scene, you encounter a restless patient who has been stabbed in the right upper quadrant of the abdomen and complaining of abdominal pain and a dry mouth. Assessment reveals no immediate life threats to the airway or breathing. The radial pulse is rapid and weak and the skin cool and diaphoretic. Vital signs​ are: pulse​ 124, respirations​ 20, blood pressure​ 122/88, and SpO2​ 97%. The injury is isolated with no involvement of the​ head, neck, or back. In managing the scene and​ patient, what observation would cause you to immediately​ intervene?

Family giving the patient water to drink.

A​ 74-year-old female is complaining of abdominal pain after falling down five stairs and hitting her abdomen and left hand on a mailbox at the bottom. She also states pain to her left wrist and right​ ankle, both of which show obvious deformity. She is alert and​ oriented, and her abdomen is free of bruising but is tender to the left upper and lower quadrants. Her vital signs​ are: pulse​ 132, respirations​ 22, blood pressure​ 106/86, and SpO2 at​ 93%. Oxygen has been​ applied, and she is fully immobilized. Advanced life support has been requested and is 12 minutes away. What is your next​ action?

Initiate immediate transport.

You are assessing the abdomen of a​ 16-year-old female that was kicked by a horse earlier in the day. You notice a bluish discoloration around the belly button. What does this finding​ mean?

It is a late sign of intraabdominal bleeding.

Which of the following abdominal organs would be characterized as being solid despite containing a large amount of​ blood?

Liver.

An industrial worker has sustained a laceration to his abdomen. On closer​ inspection, you note what appears to be fat tissue and a portion of intestine protruding through the wound. Which one of the following is most appropriate for treating this​ injury?

Occlusive dressing applied over​ saline-soaked gauze.

What age bracket of patients is MOST likely to suffer injury to the liver and spleen from blunt abdominal​ trauma?

Pediatric.

Which of the following causes​ immediate, excruciating​ pain?

Peritonitis.

A​ 16-year-old male has been struck in the genitalia by a baseball. Assessment indicates a tremendous amount of edema as well as hematoma formation and bruising to his scrotum. The primary assessment reveals no​ life-threatening conditions;​ however, he is crying and rates the pain as a​ 10/10. Which one of the following is most appropriate for this​ patient?

Placing cool compresses to the testicles.

The​ liver, spleen, and pancreas are examples of what type of abdominal​ organs?

Solid.

When you are assessing the abdomen of a​ 25-year-old male you note that he has a large piece of glass sticking out of his right upper quadrant. What should you do about​ this?

Stabilize it and administer oxygen.

An object impaled in the abdomen should​ be:

Stabilized in place.

Injuries to the genitalia​ are:

Usually embarrassing for the patient.

Which​ organ, if seriously​ injured, would cause the most rapid​ death?

Vena cava.


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