- Inspect and dress known wounds.
- Abdominal evisceration – Control bleeding; rinse with clean (and warm if possible) fluid to reduce gross contamination. Hemorrhage control – apply combat gauze or CoTCCC-recommended hemostatic dressing to uncontrolled bleeding. Cover exposed bowel with a moist, sterile dressing or sterile water-impermeable covering.
- Reduction: do not attempt if there is evidence of ruptured bowel (gastric/intestinal fluid or stool leakage) or active bleeding.
- If no evidence of bowel leakage and hemorrhage is visibly controlled, a single brief attempt (<60 seconds) may be made to replace/reduce the eviscerated abdominal contents.
- If unable to reduce; cover the eviscerated organs with water impermeable non-adhesive material (transparent preferred to allow ability to re-assess for ongoing bleeding); examples include a bowel bag, IV bag, clear food wrap, etc. and secure the impermeable dressing to the patient using adhesive dressing (examples: ioban, chest seal).
- Do NOT FORCE contents back into abdomen or actively bleeding viscera.
- The patient should remain NPO.