Chest and Abdominal Trauma

Mechanism of Injury (MOI)

100

A patient falls from 20 ft and lands on their feet. Which abdominal organ is most likely injured?

Kidneys (retroperitoneal shearing/compression)

200

In an MVC, improper seatbelt placement can cause this type of abdominal organ injury.

Compression injury to hollow organs (bowel, bladder)

300

This injury pattern occurs when internal organs continue to move forward after sudden deceleration.

Shearing injury (common in the liver, spleen, and intestines).

400

A baseball to the chest causes sudden cardiac arrest. What is this called?

Commotio cordis.

500

A blast injury can cause both blunt and penetrating trauma. Name the two phases of injury.

Primary shock wave (blunt compression) and secondary fragments (penetrating).

Signs & Symptoms

100

Muffled heart sounds, JVD, and hypotension.

Cardiac tamponade (Beck’s triad).

200

Unequal chest rise, absent lung sounds, tracheal deviation, hypotension.

Tension pneumothorax

300

Bright red blood in urine after blunt trauma.

Lower urinary tract injury.

400

Patient with abdominal distention, guarding, and rigidity

Peritonitis from hollow organ rupture

500

Paradoxical chest movement on inspiration

Flail chest

Solid vs Hollow

100

Liver

Solid

200

Small intestine

Hollow

300

Kidneys

Solid (retroperitoneal)

400

Stomach

Hollow

500

Spleen

Solid (highly vascular)

The Deadly Dozen

100

Air in the pleural space that collapses the lung

Pneumothorax

200

Chest wall injury with two or more adjacent ribs fractured in two or more places

Flail chest

300

Blood in the pleural space

Hemothorax

400

Traumatic rupture of this large vessel is often fatal at the scene

Aortic disruption.

500

Cyanosis, JVD, swelling in the face/neck/upper chest due to compression injury.

Traumatic asphyxia. (Esophageal Injury)

What's you going to do about it

100

Best immediate management for an open pneumothorax

Occlusive dressing (vented preferred)

200

First step in managing an abdominal evisceration.

Cover with a moist, sterile dressing; don’t replace organs.

300

IV fluid resuscitation goal in abdominal hemorrhage.

Maintain SBP 80–90 mmHg (permissive hypotension).

400

Proper needle decompression site for tension pneumo.

2nd intercostal space, midclavicular line OR 5th intercostal space, anterior axillary line (depending on protocol).

500

Trauma patients with suspected abdominal bleeding should be transported to this type of facility.

Trauma center with immediate surgical capability.