Medical Lane
M9

ABDOMINAL WOUND & EYE INJURIES

7 minutes

Conditions: IED immobilized lead vehicle. Open abdominal wound with organs outside body and eye injury. Non-CBRNE, casualty is conscious.

Understanding This Task

This complex task combines abdominal wound treatment with four types of eye injury treatment. The abdominal wound requires moist then dry dressing without applying pressure. For eye injuries, remember to cover BOTH eyes to prevent sympathetic movement.

Critical rule: Do NOT push organs back in. Do NOT give food or water. Do NOT reposition an eyeball.

Common NO-GO Mistakes

  • Pushing organs back inside body
  • Applying pressure to abdominal dressing
  • Only covering injured eye (must cover BOTH)
  • Attempting to reposition or replace eyeball in socket
  • Giving food or water to abdominal wound casualty

Task Basis: 081-COM-1001, 081-831-1025, 081-000-0127, 081-833-0057, 081-COM-1055

ATP 4-02.11 Doctrine

From Army Techniques Publication 4-02.11, 23 March 2026 — Chapter 14: Expedient Techniques for Secondary Injuries; Chapter 10: Eye Trauma

Abdominal evisceration — knees-flexed position (para 14-3, 14-4): The most serious abdominal wound is one where an object penetrates the abdominal wall and pierces internal organs or large blood vessels — death can occur rapidly. The first step is to position the casualty: place and maintain on their back with knees in an upright (flexed) position. The knees-up position helps relieve pain, assists in the treatment of shock, prevents further bowel exposure, and allows the abdominal muscles to relax. Do NOT probe, clean, or remove any foreign object from the abdomen. Do NOT touch exposed organs with bare hands. Do NOT push organs back inside the body.

Moist dressing application (para 14-5): Protruding abdominal organs must be kept moist to prevent tissue from drying out. Gently pick up any organs on the ground using a clean dry dressing and place on top of the abdomen. Moisten the dressing with clean water prior to placing over the exposed organs. Ensure the dressing is large enough to cover the entire mass. Do NOT give the casualty food or water. Tie the dressing loosely at the casualty's side — do NOT put pressure on the wound or tie tails directly over the dressing.

Eye trauma — types and both-eyes rule (para 10-5, 10-6, 10-7): If a penetrating eye injury is seen or suspected, cover the injured eye with a rigid eye shield — not a pressure patch. Place a concave (domed) shield over the injured eye and tape at 45 degrees across the forehead and cheek. Do NOT apply any pressure to the injured eye. Rigid eye shields should be placed over both eyes only when you are sure or at least suspect both eyes have been injured. When only one eye is injured, do NOT shield the uninjured eye — blindness in an ambulatory casualty creates an unnecessary litter casualty and is psychologically stressful.

Eye injury categories (para 10-14): Categorize injuries as: injury to tissue surrounding the eye (lacerations and contusions); injury to the eyeball itself; extrusion (eye protruding from socket); foreign bodies; or protruding (impaled) objects. For lacerations or cuts to the eyeball — cover with a loose sterile dressing with no pressure. The eyeball contains fluid; pressure applied over the eye will force the fluid out, causing permanent injury.

Source: ATP 4-02.11, Chapter 14, para 14-3 through 14-11; Chapter 10, para 10-5 through 10-19

Timer: 7 Minutes
7:00
Critical Notes
  • Do NOT push organs back in. Do NOT give food or water.
  • Cover with moist THEN dry dressing.
  • Cover BOTH eyes for eye injuries (prevents sympathetic movement).

PERFORMANCE MEASURES

0/9 GO
  1. 1

    Check for entry and exit wounds

    • Sit casualty up or roll to side to check back.
  2. 2

    Position the casualty

    • On back, flex knees. Turn head to side (airway clear for vomiting).
  3. 3

    Expose the wound CRITICAL

    • Pick up organs on ground using clean, dry dressing — gently place on abdomen.
    • Do NOT probe, clean, try to remove foreign objects, or push organs back inside body.
  4. 4

    Apply moist sterile abdominal dressing

    • Ensure dressing large enough to cover entire mass.
    • Place sterile side of plastic wrapper directly over wound.
    • Place dressing on wound — do NOT apply pressure.
    • Tie tails loosely at side.
  5. 5

    Treat for shock

    • Loosen binding clothing. Prevent chilling/overheating.
    • If vomiting: roll to side without causing further injury. Return to supine with knees flexed when done.
  6. 6

    Treat eye lacerations/contusions

    • Close lid of affected eye. Do NOT apply pressure or manipulate globe.
    • Cover with moist sterile dressing. Place field dressing over eye pad.
  7. 7

    Treat eyeball injury

    • Do NOT reposition globe or replace in socket.
    • Cover with sterile saline-soaked dressing. Field dressing over eye pad.
    • Tell casualty not to squeeze eyelids.
  8. 8

    Treat extrusion

    • Cut hole in layers of dressing material, moisten with saline.
    • Place so globe protrudes through hole without touching. Build up dressing higher than globe.
    • Apply Fox eye shield or improvised protection (paper cup, SAM splint, eyewear). Secure with tape.
  9. 9

    Treat protruding object

    • Immobilize object. Dress with moist, loose dressing.

Go Deeper — ATP 4-02.11 Reference

Detailed doctrine from the Army Techniques Publication:

Abdominal & Thoracic Wounds (Evisceration, Dressing) Eye Trauma (Shield, No Pressure, Both-Eyes Rule)
M8: Open Head Wound M10: Fracture & Burn