Abdominal injuries can damage the liver, spleen, kidneys, bowel and major blood vessels, often with little to see on the outside. They result from road crashes, falls, crush injuries, sporting impacts, blows with blunt objects and penetrating wounds. The most valuable clue for a first aider is the history of what happened, because a person with a heavy impact to the abdomen may be bleeding internally while looking deceptively well.
Signs of Abdominal Injuries
- Pain at the site of injury, or spreading across the abdomen
- Nausea and vomiting
- A hard, rigid or swollen abdomen
- Breathing that is shallow or grunting because of pain
- Signs of shock: pale, cold, sweaty skin, a fast weak pulse and drowsiness
- Blood in vomit, urine or stool, including dark offensive-smelling stools
- An open wound, or protruding intestines
Pass on the history to the ambulance crew, even if it seems unimportant to you.
Abdominal Injuries First Aid for a Conscious Person
- Call the emergency number and describe the mechanism of injury.
- Manage DRABC following our primary survey guide.
- Position for comfort and to relax the abdominal wall. Lay them on their back with head and shoulders slightly raised and knees bent over a rolled blanket or bag.
- Loosen clothing around the neck, chest and waist.
- Control any external bleeding with pressure around the wound as in severe bleeding first aid.
- Cover them with a blanket without overheating, and insulate from the ground.
- Give nothing by mouth, because surgery may be needed and vomiting is likely.
- Monitor breathing, pulse and alertness every five minutes and treat shock using shock first aid.
Protruding Intestines (Evisceration)
If bowel or other organs are visible through a wound, do not push them back and do not touch them more than necessary. Lightly cover them with a large, non-stick sterile dressing or a layer of clean plastic cling wrap, and secure it loosely. If you only have a cloth, soak it with clean water or sterile saline first, because a dry dressing sticks to the tissue. Keep the knees bent and do not apply pressure.
If the Person Is Unconscious
Clear the airway and follow the DRABC steps. If breathing, place them in the recovery position, taking care not to lie them on an obvious wound if you can avoid it, and manage as above. Start CPR if breathing is absent.
Why Abdominal Injuries Are Easy to Underestimate
Bleeding from the liver, spleen or a torn blood vessel can fill the abdomen with blood without any outward sign. Young, fit people can compensate for a time and then collapse suddenly. For that reason anyone with significant abdominal trauma needs hospital assessment even if they feel fine. See our guide to internal bleeding.
Preventing Abdominal Injuries at Work and Play
Workplace abdominal injuries come from falls, crush hazards, struck-by incidents and machinery. Guarding, safe vehicle practices, seatbelts and correct lifting reduce the risk, while sport requires protective equipment and fair play. Knowing the signs of abdominal injuries lets supervisors act quickly when a worker is hit or crushed, even if they insist they are fine.
Frequently Asked Questions
Should I press on a painful abdomen to check it?
No. Pressing can worsen the injury. Observe, ask questions and let hospital staff examine it.
Can I give water for thirst?
No. Wet the lips if needed, but give no drink, because surgery may be needed.
References and Further Reading
- American Heart Association and American Red Cross, Guidelines for First Aid
- NHS, Abdominal pain and trauma overview
- St John Ambulance, First aid advice
Last updated: October 2026
Prepared by: EHS Guidelines Editorial Team
This article is general educational information and is not a substitute for accredited first aid training or professional medical care. In an emergency, call your local emergency number immediately. Emergency numbers, medicines and protocols differ between countries, so follow local guidance.
Related Guides
- Internal Bleeding: Hidden Signs, History Clues and First Aid
- Shock First Aid: Recognising Circulatory Shock and Acting Fast
- Severe Bleeding First Aid: Direct Pressure, Dressings and Tourniquets
- The Secondary Survey: A Head to Toe Patient Examination
- Vital Signs Observations: Pulse, Breathing, Conscious State and Skin
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