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Module 5: Abdominal Injuries

Segment 2: The Bariatric Trauma Patient

References labeled PEDS contain a pediatric element or primary focus.

Topic: The bariatric trauma patient

  • Abou Zeid H, Kallab R, Najm MA, et al. Safety and efficacy of nonsteroidal anti-inflammatory drugs (NSAIDs) used for analgesia after bariatric surgery: A retrospective case-control study. Obes Surg. 2019;29(3):911-916. doi: 10.1007/s11695-018-3608-y https://pubmed.ncbi.nlm.nih.gov/30484174/.
  • Adams A, Zaryske LG. External jugular vein peripheral intravenous catheters: An emergency nurse’s guide. J Emerg Nurs. 2022;48(3):303-309. doi: 10.1016/j.jen.2022.01.009 https://pubmed.ncbi.nlm.nih.gov/35526875/.
  • Akinnusi ME, Pineda LA, El Solh AA. Effect of obesity on intensive care morbidity and mortality: A meta-analysis. Crit Care Med. 2008;36(1):151-8. doi: 10.1097/01.Ccm.0000297885.60037.6e https://pubmed.ncbi.nlm.nih.gov/18007266/.
  • Armstrong LR, Rutherford NR, Heidel RE, et al. The effect of BMI on eFAST accuracy in trauma by residents in the emergency room. Am Surg. 2023;89(7):3238-3240. doi: 10.1177/00031348231157851 https://pubmed.ncbi.nlm.nih.gov/36800399/.
  • Aryan N, Grigorian A, Nahmias J, et al. Impact of obesity on outcomes of surgical stabilization of rib fractures. J Trauma Acute Care Surg. 2026;100(1):54-59. doi: 10.1097/ta.0000000000004788 https://pubmed.ncbi.nlm.nih.gov/41198081/.
  • Atkins K, Cairns B, Schneider A, et al. An evaluation of the “obesity paradox” in isolated blunt abdominal trauma in the United States. Injury. 2024;doi: 10.1016/j.injury.2024.111612 https://pubmed.ncbi.nlm.nih.gov/38759489/.
  • Brown CV, Rhee P, Neville AL, et al. Obesity and traumatic brain injury. J Trauma. 2006;61(3):572-6. doi: 10.1097/01.ta.0000200842.19740.38 https://pubmed.ncbi.nlm.nih.gov/16966989/.
  • Buetti N, Abbas M, Pittet D, et al. Comparison of routine replacement with clinically indicated replacement of peripheral intravenous catheters. JAMA Intern Med. 2021;doi: 10.1001/jamainternmed.2021.5345 https://pubmed.ncbi.nlm.nih.gov/34533191/.
  • Chen AZL, Lee TH, Hsu J, et al. “The armor phenomenon” in obese patients with penetrating thoracoabdominal injuries: A systematic review and meta-analysis. J Trauma Acute Care Surg. 2022;93(3):e101-e109. doi: 10.1097/ta.0000000000003566 https://pubmed.ncbi.nlm.nih.gov/35195099/.
  • Day DL, Conde F. Evaluation of dwell time for peripheral intravenous catheters started in the field for geriatric blunt trauma patients. J Trauma Nurs. 2018;25(3):165-170. doi: 10.1097/jtn.0000000000000362 https://pubmed.ncbi.nlm.nih.gov/29742628/.
  • Dossett LA, Heffernan D, Lightfoot M, et al. Obesity and pulmonary complications in critically injured adults. Chest. 2008;134(5):974-980. doi: 10.1378/chest.08-0079 https://pubmed.ncbi.nlm.nih.gov/18719063/.
  • Duane TM, Dechert T, Aboutanos MB, et al. Obesity and outcomes after blunt trauma. J Trauma. 2006;61(5):1218-21. doi: 10.1097/01.ta.0000241022.43088.e1 https://pubmed.ncbi.nlm.nih.gov/17099532/.
  • Engels PT, Passos E, Beckett AN, et al. IV access in bleeding trauma patients: a performance review. Injury. 2014;45(1):77-82. doi: 10.1016/j.injury.2012.12.026 https://pubmed.ncbi.nlm.nih.gov/23352673/.
  • Erdle B, Höhne M, Diallo TD, et al. Neutralizing the odds: Biomechanical protection by adiposity offsets physiological burden to explain the trauma ‘obesity-paradox’. Injury. 2025;57(2):112913. doi: 10.1016/j.injury.2025.112913 https://pubmed.ncbi.nlm.nih.gov/41319408/.
  • Gray S, Dieudonne B. Optimizing care for trauma patients with obesity. Cureus. 2018;10(7):e3021. doi: 10.7759/cureus.3021. https://pubmed.ncbi.nlm.nih.gov/30254810/.
  • Han IH, Son DW, Nam KH, et al. The effect of body mass index on intra-abdominal pressure and blood loss in lumbar spine surgery. J Korean Neurosurg Soc. 2012;51(2):81-5. doi: 10.3340/jkns.2012.51.2.81 https://pubmed.ncbi.nlm.nih.gov/22500198/.
  • Lin CH, Lu CW, Lin YC, et al. Evaluation of the cushion effect in blunt abdominal trauma patients: A computerized analysis. Injury. 2024;55(9):111677. doi: 10.1016/j.injury.2024.111677 https://pubmed.ncbi.nlm.nih.gov/38926016/.
  • Nasraway SA, Jr., Albert M, Donnelly AM, et al. Morbid obesity is an independent determinant of death among surgical critically ill patients. Crit Care Med. 2006;34(4):964-70; quiz 971. doi: 10.1097/01.Ccm.0000205758.18891.70 https://pubmed.ncbi.nlm.nih.gov/16484910/.
  • Neville AL, Brown CV, Weng J, et al. Obesity is an independent risk factor of mortality in severely injured blunt trauma patients. Arch Surg. 2004;139(9):983-7. doi: 10.1001/archsurg.139.9.983 https://pubmed.ncbi.nlm.nih.gov/15381617/.
  • Newell MA, Bard MR, Goettler CE, et al. Body mass index and outcomes in critically injured blunt trauma patients: weighing the impact. J Am Coll Surg. 2007;204(5):1056-61; discussion 1062-4. doi: 10.1016/j.jamcollsurg.2006.12.042 https://pubmed.ncbi.nlm.nih.gov/17481540/.
  • Rice TM, Zhu M. Driver obesity and the risk of fatal injury during traffic collisions. Emerg Med J. 2014;31(1):9-12. doi: 10.1136/emermed-2012-201859 https://pubmed.ncbi.nlm.nih.gov/23337422/.
  • Russotto V, Casey JD, Myatra SN, et al. Airway management in critically ill patients with obesity. Intensive Care Med. 2026;52(6):1256-1268. doi: 10.1007/s00134-026-08454-x https://pubmed.ncbi.nlm.nih.gov/42126552/.
  • Slaton J, Nahmias J, Aryan N, et al. Association of obesity with respiratory complications in trauma patients undergoing emergent surgery. J Surg Res. 2026;322:298-304. doi: 10.1016/j.jss.2026.03.076 https://pubmed.ncbi.nlm.nih.gov/41996976/.
  • Smadi Z, Diab AR, Alsaidi A, et al. Obesity is associated with higher 90-day and 2-year complication rates following surgical fixation of upper extremity fractures: A nationwide analysis. Injury. 2025;56(12):112891. doi: 10.1016/j.injury.2025.112891 https://pubmed.ncbi.nlm.nih.gov/41273807/.
  • Smadi Z, Lingam S, Muwalla R, et al. Weight on the fixation: The influence of body mass index on lower extremity fracture fixation outcomes. Injury. 2025;56(12):112864. doi: 10.1016/j.injury.2025.112864 https://pubmed.ncbi.nlm.nih.gov/41197500/.
  • Swaminathan L, Flanders S, Horowitz J, et al. Safety and outcomes of midline catheters vs peripherally inserted central catheters for patients with short-term indications: A multicenter study. JAMA Intern Med. 2021;doi: 10.1001/jamainternmed.2021.6844 https://pubmed.ncbi.nlm.nih.gov/34842905/.
  • Tracy BM, Wilson JM, Staley C, et al. Metabolic syndrome: Major risk factor for morbidity and mortality in severely injured trauma patients. J Am Coll Surg. 2020;230(1):145-150. doi: 10.1016/j.jamcollsurg.2019.09.009 https://pubmed.ncbi.nlm.nih.gov/31672670/.
  • VanHoy SN, Laidlow VT. Trauma in obese patients: implications for nursing practice. Crit Care Nurs Clin North Am. 2009;21(3):377-89, vi-vii. doi: 10.1016/j.ccell.2009.07.004 https://pubmed.ncbi.nlm.nih.gov/19840716/.
  • Verhoeff K, Saybel R, Mathura P, et al. Ensuring adequate vascular access in patients with major trauma: a quality improvement initiative. BMJ Open Qual. 2018;7(1):e000090. doi: 10.1136/bmjoq-2017-000090 https://pubmed.ncbi.nlm.nih.gov/29333494/.
  • Wee SY, Li C, Su WT, et al. Obesity and short-term outcomes in blunt liver trauma with and without surgical repair: evidence from the United States Nationwide Inpatient Sample 2005-2020. Surg Endosc. 2025;39(12):8089-8098. doi: 10.1007/s00464-025-12210-5 https://pubmed.ncbi.nlm.nih.gov/40944742/.
  • Zander C, Mühlenfeld N, Erdle B, et al. Association of CT-derived adipose measurements with prolonged intensive care unit stay in moderate and severe trauma patients. Injury. 2026;doi: 10.1016/j.injury.2026.113625 https://doi.org/10.1016/j.injury.2026.113625.

Topic: Vascular access

  • Chreiman KM, Dumas RP, Seamon MJ, et al. The intraosseous have it: A prospective observational study of vascular access success rates in patients in extremis using video review. J Trauma Acute Care Surg. 2018;84(4):558-563. doi: 10.1097/ta.0000000000001795 https://pubmed.ncbi.nlm.nih.gov/29300281/.
  • Dumas RP, Succar B, Vella MA, et al. Stick or switch: The diminishing returns of repeated peripheral intravenous access attempts in hypotensive trauma patients. J Am Coll Surg. 2026;doi: 10.1097/xcs.0000000000002027 https://pubmed.ncbi.nlm.nih.gov/42095559/.
  • Proehl JA, Campos C. The role of the nurses in the use of intraosseous vascular access devices. J Emerg Nurs. 2025;51(4):515-518. doi: 10.1016/j.jen.2025.03.014 https://pubmed.ncbi.nlm.nih.gov/40602838/.
  • Qasim ZA, Joseph B. Intraosseous access in the resuscitation of patients with trauma: the good, the bad, the future. Trauma Surg Acute Care Open. 2024;9(Suppl 2):e001369. doi: 10.1136/tsaco-2024-001369 https://pubmed.ncbi.nlm.nih.gov/38646033/.

Topic: Specific restraint injuries and predictors of injury

  • Forman J, Poplin GS, Shaw CG, et al. Automobile injury trends in the contemporary fleet: Belted occupants in frontal collisions. Traffic Inj Prev. 2019;20(6):607-612. doi: 10.1080/15389588.2019.1630825 https://pubmed.ncbi.nlm.nih.gov/31283362/.
  • Mohs ZA, Albrecht N, Duncan AJ, et al. Pelvic fractures and thoracolumbar spine injury: A critical overlook in high-impact vehicular trauma management. Injury. 2024;doi: 10.1016/j.injury.2024.112050 https://pubmed.ncbi.nlm.nih.gov/39642601/.
  • Serag I, Scherer J, Popescu EC, et al. A meta-analysis of the incidence of intra-abdominal injuries associated with thoracic or lumbar flexion-distraction injuries. Injury. 2025;56(6):112337. doi: 10.1016/j.injury.2025.112337 https://pubmed.ncbi.nlm.nih.gov/40273660/.