Chapter 35
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.
