![]() Reasonably well-supported contraindications Preverbal children with mild-to-moderate injuries.Direct blow to the abdomen from bicycle handlebars or kicking.Suspected non-accidental trauma to the abdomen.Free fluid on bedside ultrasound FAST examination.Persistent complaints of abdominal pain.Children with spinal cord injuries resulting in loss of.Intubated children undergoing mechanical ventilation.DPL no longer has a central role in the management of blunt abdominal trauma.ĬT scan Reasonably well-supported indications DPL (diagnostic peritoneal lavage) is not indicated in a blunt trauma patient with normal vital signs. Plain radiographs of abdomen are not recommended in the trauma patient. ![]() It will be unsafe to discharge patient home even after 4 hours observation in ED.13 times as likely to have a gastrointestinal injury.patient have 3 times greater chance of having an underlying abdominal injury.Seat belt sign is a clue for possible underlying abdominal injury discharge home with follow up in 24 hours ĭischarge home with follow up in 24 hours.What is the most appropriate next step in management? Plain x-ray of lumbar spine is normal and a FAST scan is negative. Physical examination reveals lumbar spine tenderness and bilateral lower quadrant abdominal tenderness with a band like area of ecchymosis over the lower abdomen. His airway is patent, he is comfortable on RA. vital signs BP 102/54mmHg, HR 105 bpm, RR 22 bpm. He presents to the ED complaining of abdominal and lower back pain. A 10 year old was a rear seat passenger who was wearing a lap belt in a vehicle that was struck from behind while at a red light.
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