Regarding abdominal evisceration, which action is contraindicated?

• A. Replacing protruding organs into the abdomen
• B. Covering with moist sterile gauze
• C. Securing with an occlusive dressing
• D. Transporting promptly

Answer: (A)

When abdominal contents are exposed, the main goal is to protect those tissues, prevent infection, and get the patient to definitive care quickly. Replacing protruding organs back into the abdomen is not done by EMTs. Pushing them back can cause further tissue damage, tear vessels, spread bacteria into the abdominal cavity, and compromise blood supply to the tissues. The proper approach is to gently cover the organs with moist sterile dressings to keep them moist, then seal and protect with an occlusive dressing to prevent drying and heat loss, while initiating rapid transport. Avoid trying to reinsert the organs, and don’t apply dry dressings or apply pressure to the exposed tissues. Keep the patient warm and monitor for signs of shock en route to the hospital.