Penetrating and Blunt Abdominal Trauma

The author discussed, in detail, the various medical interventions done on the patients and their possible complications that arose during the duration of their hospitalization. As for the health assessment procedure rationales mentioned in this journal, Eckert discussed a flow of the procedures. Observation as to the patient’s appearance upon encounter is to be done first. Presence and location of wounds as well as the depth and entrance and exits sites for penetrating wounds should be noted. Next, the author noted that auscultation is to be done prior to palpation as to prevent alteration of bowel sounds due to manipulation (p.53). Presence or absence of bowel sounds should be done comprehensively, covering all 4 quadrants. Nurses should check the quality, frequency and any abnormality in the bowel sounds. Auscultation over major blood vessels not only in the abdominal area but also in near regions that may be affected such as the femoral vessels should be checked. Palpation will elicit the presence of abdominal tenderness, rebound tenderness, guarding, texture of abdomen and any irregularities. Several organ injury scales were discussed by Eckert. Among the scales mentioned that were being used in the nursing practice were the 6-level Liver Injury Scale, the 5-level Splenic Injury Scale, 5-level Kidney Injury Scale, and 5-level Pancreatic Injury Scale. The
Penetrating and Blunt 3
population discussed in this journal is the patients with abdominal trauma. Most, if not all of the cases in this journal were emergency or acute cases.
I think that among the strengths of this journal is the comprehensiveness and practicality of this journal to nursing practice. Its use of case studies gives the reader a picture of what is to be encountered in the emergency rooms or intensive care units in the hospital setting. It was very thorough in explaining the different procedures done on the patient and each of its rationale. The journal introduces to the reader some information on the anatomy and physiology of some of the vital abdominal organs which are commonly affected in abdominal trauma. This is most helpful to nursing students who are still beginners in the field for them to have an idea of the interplay between these organs. This journal also gives information on the ancillary procedures usually done on the patients, highlighting the most pertinent or practical for each case or organ. For example, the author stated that the CT scan is the most sensitive diagnostic tool for most abdominal trauma injuries and between the FAST scan and the diagnostic peritoneal lavage (DPL), the FAST scan is more utilized in most emergency cases because it is non-invasive and inexpensive compared to DPL. Also to be commended is the use of some visuals such as pictures of the different interventions. It also made use of some flow charts or concepts maps in nursing assessment in specific situations and included the indications for surgery and admittance to the ICU.
This article was able to capture my interest because it is easy to understand and very thorough in explaining the various assessments, procedures and treatments involved in patients with