The treatment of patients with blunt abdominal trauma is first guided by initial stabilization and then ultimately, by diagnosis. Pain control is an important step in initial management that can be easily overlooked in a complex case. In a hemodynamically unstable patient, fluid resuscitation should begin with crystalloid and then progress to blood, as explained previously. Patients with low systolic blood pressure despite fluid resuscitation should be taken for emergent laparotomy. A positive FAST in this case can aid in determining whether the bleeding is originating from the abdomen. However, a negative FAST should not delay surgical exploration. A hemodynamically stable patient can undergo diagnostic testing and can be observed with the use of serial abdominal examinations to monitor for any changes.
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