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Blunt abdominal trauma is common following major traumatic injury but may not be recognised quickly enough and is therefore a cause of preventable death in trauma patients. Emergency department nurses have a major role to play in reducing the incidence of unrecognised abdominal trauma by enhancing their knowledge and skills. They can do this by attending trauma-related courses, taking on more expanded roles, carrying out full and comprehensive physical assessments, and ensuring that members of the multidisciplinary team use the wide range of diagnostic adjuncts available to them. This article reviews the anatomy and physiology of the abdominal cavity, explains abdominal trauma, gives an overview of advanced abdominal assessment techniques and diagnostic adjuncts, and reviews some management strategies for uncontrolled haemorrhage that have been adopted in the UK.

This paper describes the assessment, investigation and management of patients suffering blunt abdominal trauma. Many of the structures within the abdominal cavity are highly vascular and damage following trauma can lead to life-threatening hypovolaemia. Initial assessment of the patient must follow the usual trauma protocols with identification and management of life-threatening conditions; specific procedures related to the abdomen are described. Although formal examination of the patient has traditionally been a medical responsibility, nurses are assuming more responsibility by working in triage or as nurse practitioners. Nurses working both in triage and within the Accident and Emergency department must be able to rapidly assess these patients and assist in their management.