Abdominal Pain (Adult)
Abdominal Pain (Adult)
EMT Standing Orders
- Routine Patient Care
- Maintain the patient NPO (nothing by mouth)
- Allow the patient to assume a position of comfort.
- Acquire and transmit 12-lead ECG, if available, for patients aged≥40.
- Minimize scene time.
- Establish IV access
- If the patient has uncontrolled pain, unstable vital signs, or signs and symptoms of an acute abdomen, Call for AEMT/Paramedic intercept & assist them in patient care.
AEMT/PARAMEDIC STANDING ORDERS:
- Establish IV access
- See Nausea/Vomiting Protocol (47 Medical).
- If the patient is hypotensive, see Shock Protocol – Adult (56 Medical).
- Contact Medical Direction for additional fluid orders.
- See Pain Management Protocol – Adult (41 Medical).
- Assess and monitor the cardiac rhythm, treat as indicated.
PEARLS
Obtain a complete abdominal history:
- History of pain (OPQRST)
- History of recent trauma
- History of nausea/vomiting (color, bloody, coffee grounds)
- History of bowel movement (last BM, diarrhea, bloody, tarry)
- History of urine output (painful, dark, bloody)
- History of prior abdominal surgery
- History of acute onset of back pain
- History of last menses in female/vaginal bleeding/pelvic pain
- History of anticoagulant medication
- SAMPLE history
Abdominal physical assessment:
- Ask the patient to point to the area of pain (palpate this area last).
- Gently palpate for tenderness, distention, rigidity, guarding, and pulsatile masses. Also, palpate the flank for CVA (costovertebral angle) tenderness.
- An acute abdomen is rigid with guarding, distension, and diffuse tenderness and may indicate a surgical emergency. An acute abdomen can be caused by many things including the following: appendicitis, cholecystitis, duodenal ulcer perforation, diverticulitis, abdominal aortic aneurysm, kidney infection, urinary tract infection,