In an open abdominal injury with protruding organs, which on-scene action is recommended?

• A. High-priority transport
• B. Cover protruding organs with a moist sterile dressing
• C. Push protruding organs back inside
• D. Apply direct pressure to control bleeding

Answer: (B)

When tissue is exposed through an open abdominal injury, the priority on scene is to protect the protruding organs from drying out and from contamination while you arrange rapid transport. The best action is to cover the exposed tissues with a moist sterile dressing. Keeping the organs moist helps preserve tissue viability, reduces the risk of infection, and minimizes additional trauma from environmental exposure. It also helps prevent further dehydration of the viscera and makes later handling safer for you and the patient.

Never try to push the organs back inside. Replacing them can cause further injury and can drive contaminants deeper into the wound, increasing the risk of infection and complicating later surgery. Also avoid applying direct pressure on the organs themselves, as that can cause additional tissue damage; if needed, you can loosely apply dressings to help secure the area without pressing on the exposed tissue.

After covering, continue with rapid transport and manage other aspects of care as indicated, such as maintaining body warmth and providing high-flow oxygen if available, while monitoring for signs of shock.