The Victorian State Trauma System provides support and retrieval services for critically injured patients requiring definitive care, transfer and management. This abdominal trauma guideline provides evidence based advice on the initial management and transfer of major trauma patients who present to Victorian health services with severe abdominal injuries. This abdominal trauma guideline is developed for all clinical staff involved in the care of trauma patients in Victoria. It is intended for use by frontline clinical staff that provide early care for major trauma patients; those working outside a Major Trauma Service (MTS) and those working directly at a Major Trauma Service (MTS). The guideline has been assessed utilising the AGREEII methodology for guideline development and is under the auspice of the Victorian State Trauma Committee (VSTC).1
Clinical Emphasis Points
Management of abdominal trauma largely depends upon the haemodynamic stability of the patient.
Blunt and penetrating abdominal trauma have different care pathways.
Widespread availability of CT scanning has seen a shift in the management of haemodynamically stable blunt abdominal trauma patients towards non-operative management.
Delay in diagnosis and treatment of hollow viscus injury leads to early peritonitis, haemodynamic instability and increased mortality and morbidity.
Consultation with ARV for advice and transfer to a MTS should be initiated for all penetrating abdominal trauma and in significant blunt trauma.