Chest  &

Abdominal Trauma




  • Time of injury
  • Type of injury
  • Mechanism (blunt vs. penetrating)
  • Open vs. closed wound/fracture
  • Wound contamination
  • Medical history
  • Medications
  • Tetanus history
  • Evidence for multi-trauma


Significant Findings:


  • Pain
  • Swelling/bleeding
  • Respiratory distress/failure
  • Altered sensation/motor function distal the injury
  • Diminished pulse/capillary refill distal the injury
  • Major traumatic mechanism of injury
  • Seat belt markings




  • Hollow/solid organ trauma
  • Grey Turner's sign (bruising at flanks)
  • Cullen's sign (bruising around navel)
  • Referred pain (caused from the brain's inability to localize area of irritation
  • Parietal pain (caused by irritation to the parietal peritoneal wall)
  • Visceral pain (caused from acute stretching of the structure's wall)




  • Oxygen
  • Limit scene time to 10 min
  • Initiate IV


Penetrating ?


  • Yes




    • Vented chest seals if indicated



Blunt ?


  • Yes





    • Notify receiving facility or contact Medical Control




  • Solid abdominal organs: lungs, liver, spleen, kidneys, pancreas. Presents with constant pain. May be referred.
  • Hollow organs: heart, stomach, intestines, bladder, gall bladder, uterus, diaphragm, appendix.  Presents with visceral, parietal or referred pain. Pain presents as intermittent ache or cramp or sharp, pinpoint pain.
  • Notify Greenville Memorial as soon as possible with:
    •  BP (or hemodynamic stability)
    • Airway status (patent, unstable or secured)
    • MOI
    • GCS
    • ETA.
  • See Trauma Alert activation standard policies 1.13 for alert criteria