Abdominal injuries are caused by blunt or penetrating trauma and can involve internal bleeding or the exposure of the internal organs to air. Such injuries invariably affect vital organs. The first aid provider should be alert for shock due to internal bleeding regardless of the injury cause or whether there is a wound or not.

Blunt or penetrating trauma Initial first aid treatment is the same whether the injury is penetrating or caused blunt trauma, eg a severe blow to the abdomen without any visible wound.

• history of the incident
• pale, cool, clammy skin
• may be evidence of wound
• rapid, weak pulse, with evidence of shock
• rapid, shallow breathing
• abdominal rigidity
• ‘guarding’ of abdomen – foetal position if lying down
• may be incontinent

• call ‘000’ for an ambulance
• stop any bleeding
• stabilise any object where it is, and pad around the wound
• if the wound permits, and the casualty is conscious, lay casualty on back and elevate legs bent at the knees
• reassurance
• avoid removing or touching penetrating objects

Evisceration Evisceration is the protrusion of abdominal organs from a wound in the abdomen.

Care must be taken not to apply material to the wound that will stick to the organs. It should be noted that often there is little pain associated with this type of injury, and the casualty may walk around or offer to help.

• obvious protrusion of organs
• pale, cool, clammy skin
• rapid, weak pulse, with evidence of shock
• rapid, shallow breathing
• may be faecal odour if organs have been lacerated
• anxiety
• nausea

• call ‘000’ for an ambulance
• cover organs with non-stick dressing (if unavailable, clean dressing kept wet or plastic wrap)
• place supporting bandage over wound
• place casualty flat with legs bent
• reassurance
• if unconscious, recovery position with legs bent
• DO NOT attempt to replace organs