ACEP ID:
Scope of Application
This guideline is intended for physicians working in hospital-based emergency departments.
Inclusion Criteria
This guideline is intended for nonpregnant adult patients presenting to the emergency department with acute, blunt abdominal trauma.
Exclusion Criteria
This guideline is not intended to address the care of pediatric patients or pregnant women.
Recommendations offered in this policy are not intended to represent the only diagnostic and management options that the emergency physician should consider. ACEP recognizes the importance of the individual physician’s judgment and patient preferences.
In a hemodynamically unstable patient with blunt abdominal trauma is bedside ultrasound the diagnostic modality of choice?
Does oral contrast improve the diagnostic performance of computed tomography (CT) in blunt abdominal trauma?
In a clinically stable patient with isolated blunt abdominal trauma, is it safe to discharge the patient after a negative abdominal computed tomography (CT) scan result?
None specified.
Clinically stable patients with isolated blunt abdominal trauma can be safely discharged after a negative result for abdominal CT with intravenous (IV) contrast (with or without oral contrast).
Further observation, close follow-up, and/or imaging may be warranted in select patients based on clinical judgment.
None specified.
Clinically stable patients with isolated blunt abdominal trauma can be safely discharged after a negative result for abdominal CT with intravenous (IV) contrast (with or without oral contrast).
Further observation, close follow-up, and/or imaging may be warranted in select patients based on clinical judgment.
In patients with isolated blunt abdominal trauma, are there clinical predictors that allow the clinician to identify patients at low risk for adverse outcome who do not need an abdominal computed tomography (CT)?
None specified.
None specified.
Patients with isolated abdominal trauma, for whom occult abdominal injury is being considered, are at low risk for adverse outcome and may not need abdominal CT scanning if the following are absent: abdominal tenderness, hypotension, altered mental status (Glasgow Coma Scale score <14), costal margin tenderness, abnormal chest radiograph, hematocrit<30% and hematuria.* *Hematuria is defined variably in different studies, with the lowest threshold being greater than or equal to 25 RBCs/high-power field (HPF).
None specified.
None specified.
Patients with isolated abdominal trauma, for whom occult abdominal injury is being considered, are at low risk for adverse outcome and may not need abdominal CT scanning if the following are absent: abdominal tenderness, hypotension, altered mental status (Glasgow Coma Scale score <14), costal margin tenderness, abnormal chest radiograph, hematocrit<30% and hematuria.* *Hematuria is defined variably in different studies, with the lowest threshold being greater than or equal to 25 RBCs/high-power field (HPF).