Lesson
Abdominal Evisceration
Objective: Cover eviscerated bowel correctly and not delay hemorrhage and airway care because of the visual.
Why This Is Hard
Bowel on the abdominal wall hijacks the crew. Meanwhile an artery is open in the thigh. ATLS: cover with moist sterile dressings, do not reduce, keep warm. Then the rest of trauma care.
On this truck
- Saline-moistened sterile dressings, then an occlusive outer layer to keep it moist — not dry gauze on mucosa.
- Do not poke it back in.
- Treat shock. This is a surgical abdomen.
Field Rules (Education)
- Do not reduce eviscerated bowel in the field.
- Moist, then protect from drying and heat loss.
- MARCH still applies. Spectacular bowel does not outrank a femoral bleed.
- Destination: trauma surgery, not a clinic.
Field Pitfalls
- Pushing bowel back.
- Dry dressings.
- Staring at the belly while the thigh pumps.
Practice
60-second drill
Partner: evisceration plus a spraying femoral. Order of the first two actions.
Related: MARCH.
Sources & Further Study
Named guidelines for further study. They are not clinical orders and do not replace your protocol or medical direction.
- NASEMSO National Model EMS Clinical Guidelines (2022) — U.S. EMS model language; protocol still wins
- ATLS education — do not reduce evisceration; moist sterile cover
Education only. Apply learning within your protocols and medical direction. This is not clinical care guidance.
Check Your Understanding
Street decisions from this lesson only. After you check, the key is highlighted. Education practice — not a certification exam.