Stable patients with blunt liver injury: observe, do not operate!

The diagnosis and treatment of liver injury have changed dramatically in the past 30 years. Because abdominal computed tomography scan now refines the diagnosis of liver injury, the observation and nonsurgical treatment of stable patients with blunt liver injury is now the standard. The need to surgically intervene should be governed by the presence of hemodynamic instability or frank peritonitis. There is ample data that validate this assertion. Implications for nurses in critical care include patient/family education and advocacy of treatment decisions and astute monitoring of the patient while in critical care.