midazolam/morphine
LA infiltration with adrenaline
3cm vertical midline incision 2cm below umbilicus (above if preganant or pelvic fracture)
Dissect to linea alba (self retainer helpful)
If kit, grasp and lift fascia then insert needle 45 deg inferiorly, pass into peritoneal cavity and slide over wire. Aim for rectovesical pouch
Aspirate, if 10mL blood found then arrange laparotomy
If not then infuse bag of saline in but do not allow to empty completely.
Put catheter bag on floor: need to get 300-350ml back for analysis
Controversy over what is positive: >500WCC/mm3 suggests small bowel or colon injury
>100 000 RBC/mm3 widely accepted but some have used 20 000
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