![]() Note that patients with this injury may also present with open wounds to the general area of the colon. Palpation may reveal a rigid abdomen in the epigastric area or left upper quadrant (LUQ). Trauma nurses should watch for signs of sepsis (tachycardia, hypotension, fever, leukocytosis). They may also experience nausea and vomiting. Patients with penetrating colon injury may report generalized abdominal pain. What are the signs and symptoms of penetrating injury to the colon? Note that patients with diaphragmatic rupture may also present with an open wound to the abdomen and/or thorax. Trauma nurses should observe closely for hypotension, tachycardia and tachypnea. Common signs include dyspnea (shortness of breath) and referred paid to the shoulder. Penetrating injury to the diaphragm may be asymptomatic at first. What are the signs and symptoms of diaphragmatic rupture? CT scans may show free fluid, air or contrast extravasation in the abdominal cavity Q. Lab tests may show an elevated white blood cell (WBC) count or an upward trend in lactic acid. Trauma nurses should observe closely for signs of hemodynamic instability. ![]() ![]() Patients with penetrating injury to the small intestine may display guarding behavior or report rebound tenderness (an increase of pain upon removal of pressure). What are the signs and symptoms of penetrating injury to the small intestine? Lab results may indicate elevated levels in any liver function test (LFT) - albumin, ALP, ALT, AST, bilirubin, lactate dehydrogenase, prothrombin time. Palpation may reveal tenderness and/or rigidity in the RUQ. The patient will often be guarding their abdomen. Inspection of the abdomen may reveal lacerations, a clear penetrating wound to the right upper quadrant (RUQ), ecchymosis (bruising) in the RUQ, and/or bruising around the umbilicus (Cullen’s sign). The most common sign of penetrating liver injury is abdominal pain. What are the signs and symptoms of penetrating injury to the liver? The most commonly injured abdominal organs seen in penetrating trauma via gunshot wounds are the liver, small intestine, diaphragm and colon. Some organs are more susceptible to GSW damage due to their location within the body cavity and surrounding structures. ![]() What organs are most commonly injured by a GSW to the abdomen? This disburses the bullet’s energy transfer to a larger surface area and creates widespread tissue damage. Certain projectiles, such as soft-tip or hollow-tip bullets, fragment upon impact with the body. Larger bullets and bullets with an irregular shape will also produce a larger surface area of damage.įragmentation. This increases the surface area of damage produced and creates further cavitation. If a bullet’s center of gravity is not midline, the imbalance can cause the bullet to turn and twist within the body tissue. The speed is highly dependent on factors such as the proximity of the firearm to the individual, the type of firearm used, and more. The most important factor influencing physical damage is the bullet’s velocity as it enters the body. Several factors influence the severity of a bullet’s damage to the body:īullet speed. What factors influence the severity of damage from a GSW? High-energy GSWs are typically produced by military-grade guns and hunting rifles. High-energy GSWs transfer the greatest kinetic energy, causing significant damage to the surrounding tissue in the path that the bullet follows through the body (also known as cavitation). These wounds are typically produced by handguns and low-caliber rifles. Medium-energy GSWs transfer a higher amount of kinetic energy to the body. The damage may be similar to a stabbing wound. Low-energy GSWs tend to cause local tissue damage via laceration of surrounding structures. These are sometimes referred to as high-, medium- and low-velocity GSWs. Gunshot wounds can be divided into three categories: high-energy, medium-energy and low-energy. They should also recognize the underlying injuries that occur to abdominal organs when penetrating trauma occurs. Trauma nurses should understand how different types of firearms and bullets cause tissue damage to the abdomen. Gunshot wounds (GSWs) to the abdomen are a relatively small portion of these incidents, but management of abdominal firearm injuries can be complex. Trauma Nursing Q&A is produced in partnership with the Board of Certification for Emergency Nursing (BCEN ®), developer of the Trauma Certified Registered Nurse (TCRN ®) certification.Īpproximately 120,000 people are injured by firearms in the U.S.
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