Trends in Reduction of Mortality in Liver Trauma

Abstract

The liver is the most frequently damaged organ in abdominal trauma. There is a high risk of hemorrhage and mortality as severity of injury and stage increases. During the last decade, management of liver trauma standards changed when the American Association of the Surgery of Trauma adjusted their guidelines to focus on early computed tomography scanning to determine the severity of liver injury trauma and the need for surgical verses nonsurgical management. Liver injury can be blunt or penetrating. Trauma teams became more multidisciplinary to focus not only on the physical but also on the psychosocial issues with trauma. Algorithms were developed to guide trauma flow and determination of severity of injury by grade. Nursing considerations and management include maintaining hemodynamic stability via accurate fluid resuscitation, monitoring of frequent vitals signs and abdominal assessment. Care must be taken to address pain and the psychosocial and emotional issues of trauma.

Keywords: Hepatic injury; Liver trauma; Nonoperative management; WSES standards.