In addition, liver function tests may be abnormal, although this may not be seen until several hours to days after injury. Trauma patients with the appropriate mechanism of injury that are seen in the trauma bay should receive a standard set of laboratory tests. This may include but is not limited to a comprehensive metabolic panel, complete blood count, coagulation parameters, and lactate level. Patients with the liver injury can have right upper quadrant tenderness, and the presence of abdominal distention can suggest hemoperitoneum.
![trauma sign trauma sign](https://3.bp.blogspot.com/-yF5rIy6_MkA/Wmz1YDB_VHI/AAAAAAAABfs/JGOBNZLG2fYMLBLs7meBiR_x1l4gEimtwCLcBGAs/s1600/5%2BSigns%2BTo%2BIdentify%2BIf%2BYou%2BHad%2BA%2BTraumatic%2BChildhood.png)
For patients with hepatic injury, the primary survey should identify the presence of hypovolemic shock from liver bleeding. Vital sign changes present in hemorrhagic shock include a narrow pulse pressure, hypotension, and tachycardia.Īfter the primary survey is completed, the secondary survey should be conducted by performing a head-to-toe exam that can identify any potential injuries. The primary survey should be conducted to identify immediately life-threatening injuries.
![trauma sign trauma sign](https://psychology.uga.edu/sites/default/files/Slide1_4.png)
As with all trauma patients, the evaluation must be guided with advanced trauma life support principles. Trauma to the anterior or lateral wall or thoracoabdominal region may raise the suspicion of a possible hepatic injury. Care of the patient with hepatic injury often begins in the trauma bay. First responders can give provide crucial information regarding the mechanism of injury that may help the clinician discern whether a liver injury may exist.