Sports-related abdominal trauma

Athletes who sustain a direct blow to the abdomen that results in injury to spleen, liver, or kidney may have immediate severe pain and may become "shocky" quickly. Trainers, EMTs, paramedics, and team physicians should be aware of this possibility. In addition, athletes who have sustained direct blow and have had slower bleeding may collapse later either on the field, on the side-lines, or at home. They will be pale, sweaty, may complain of thirst, and the pulse will be rapid and thready. If a blow has been sustained that results in abdominal pain, the athlete should not be given liquids to drink. If he has collapsed or has diffuse abdominal pain he should be kept in a recumbent position, and the legs should be elevated in order to assist blood in returning to the heart (Trendelenberg position). If hypotensive shock is present, the PASG antishock garment should be applied. In cases in which there is serious concern about an intra-abdominal injury or the patient has collapsed in shock, transport to a hospital, preferably to a trauma center, should be effected as rapidly as possible. There should not be excessive delays in starting intravenous fluids or administering time-consuming procedures in the field. Truly serious intra-abdominal injuries as a result of nonvehicular sports-related incidents are not common. It is precisely for this reason that they are dangerous. Teammates, parents, trainers, coaches, EMTs, and paramedics are not accustomed to seeing them with any frequency. Because of this, the early signs of injury are often unrecognized, even in cases that progress to shock or collapse.(ABSTRACT TRUNCATED AT 250 WORDS)