chapter 33 abdominal pain. © 2005 by thomson delmar learning,a part of the thomson corporation. all...

Chapter 33Abdominal Pain

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© 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved

Overview

Anatomy Review Causes of Abdominal Pain Assessment Management Transport

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Anatomy Review

Abdomen contains several organ systems– Digestive organs

• Stomach, small intestine, large intestine, liver, gallbladder, pancreas

– Genitourinary system• Kidneys, ureters, bladder

– Hematologic system• Spleen and blood vessels

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Causes of Abdominal Pain

Gastrointestinal: Peptic ulcer disease– Stomach acids can cause injury to the wall of the

stomach and duodenum– If there is blood vessel involvement, serious

bleeding can occur– Pain is typically in the middle of the upper

abdomen

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Gastrointestinal: Esophageal varices– Distended or ruptured veins running

through the esophagus– Results in severe bleeding

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Gastrointestinal: Gastroenteritis– Viral irritation of the stomach– Vomiting, diarrhea, abdominal pain, and fever– Can lead to dehydration and shock

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Gastrointestinal: Bowel obstruction– Narrowing or blockage can prevent

passage of wastes– Can cause distension, resulting in pain

or vomiting

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Gastrointestinal: Gallbladder disease– Gallstones accumulate and block flow of bile– Results in distension and pain in the gallbladder– Fever, right upper abdominal pain, vomiting, jaundice– Surgical removal is usually necessary

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Gastrointestinal: Appendicitis– Becomes obstructed, which causes

distension and possible rupture– Right lower abdominal pain, poor

appetite, nausea, fever– Surgical removal is required

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Gastrointestinal: Diverticulitis– Sacs in the large bowel become obstructed,

distended, and inflamed and can perforate– Abdominal pain and red blood in stool

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Gastrointestinal: Pancreatitis– Ducts that secrete enzymes become blocked,

resulting in distension and inflammation– Upper abdominal pain, vomiting

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Genitourinary: Renal stones– Particulate matter that crystallizes in urine – Can become lodged in the ureter– Severe flank pain, which can radiate to the groin– Vomiting is also common

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Genitourinary: Pyelonephritis– Infection of the kidneys– High risk of spreading infection into the bloodstream– Pain over one or both flanks, vomiting, high fever

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Genitourinary: Ectopic pregnancy– Implantation of fetus outside the uterus– Danger of the fallopian tube rupturing,

which may result in extensive bleeding– Lower abdominal pain with or without

vaginal bleeding

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Vascular: Abdominal aortic aneurysm– Weakened walls of the arteries may balloon

out, leading the wall to leak or rupture– May cause massive bleeding and death

if undetected

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Extra-abdominal– Pain felt in the abdomen when cause of

pain is not in the abdomen– Acute coronary syndrome and pneumonia

will present with abdominal pain

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Stop and Review

Name the common diseases that present with abdominal pain.

What is extra-abdominal pain? What disease processes can cause

extra-abdominal pain?

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Assessment

Initial assessment– Treat any life threats first

Focused history– Use OPQRST and SAMPLE

Focused physical examination– Visually inspect and palpate the abdomen

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Assessment

Vital signs– Repeated sets of vital signs are important to note

the progression of the patient’s condition

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Management

Abdominal pain has many causes Assume serious disease process and

assess thoroughly Manage ABCs and transport patient to

definitive care

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Transport

Initiate as soon as possible Allow patient to assume a position of

comfort during transport Consider calling ALS Continue to observe the patient en route

through the ongoing assessment

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Stop and Review

Why is the patient with abdominal pain treated as a high-priority patient?

What is the focus of the EMT’s assessment of the patient with abdominal pain?

chapter 33 abdominal pain. © 2005 by thomson delmar learning,a part of the thomson corporation. all...

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abdominal pain slide

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