Editing Trauma laparotomy (section)

=== '''If major bleeding/blood is found''' ===

* '''Consider enlarging original incision'''
* '''Lift out the small bowel completely, quickly''' (sweep from LUQ down to pelvis then out onto skin in RUQ)
* '''Evacuate the blood as fast as possible (scoop it out into a kidney dish)'''
** '''If hypotension is worsened due to release of tamponade, apply pressure to aorta at base of diaphragm until anaesthetist catches up'''
* '''Quickly review for solid organ injury'''
* '''Pack the four quadrants tightly (see below)'''
* '''If bleeding not controlled, supra-coeliac pressure/clamp'''
* '''Systematic assessment'''
** '''Unpack, suck and re-pack each quadrant consecutively'''
** '''Perform definitive haemostasis when needed'''