Abdominal Pain - EMS Online

[Pages:17]Seat t le- King Count y EMS

Emergency Medical Services Division Public Health - Seattle/King County 999 3rd Avenue, Suite 700 Seattle, Washington 98104 (206) 296-4863 January 2007

CBT/ OTEP 435

Abdom inal Pain

print version of EMS Online Course em

Copyright ? 2007 Seat t le- King Count y EMS

CBT/OTEP 435 Abdominal Pain

I ntroduction

The abdom en has m any organs and com plex st ruct ures. Det erm ining t he cause of an abdom inal com plaint is challenging even for experienced health professionals.

Your goal in assessing abdom inal pain is t o det erm ine if a pat ient is SI CK or NOT SI CK and init iat e care. You do not have t o spend a lot of t im e t rying t o figure out t he cause. I f tim e is available, assess the quality and location of the pain and if there are abnorm alities in the abdomen.

Before You Begin This is a cont inuing educat ion and recert ificat ion course for EMTs. I t covers fundam ent al EMT- Basic concept s and t erm inology as well as advanced m at erial. We highly recom m end com pleting the case studies and practice exam before com pleting the exam .

We also recom m end t hat you review an EMT t ext book chapt er covering st roke as a refresher before t aking t he exam ; for exam ple: Chapt er 14 in Em ergency Care and Transport at ion of t he Sick and I nj ured, 9t h edit ion ( AAOS) .

Practical Skills To receive CBT or OTEP credit for t his course a t rained skills evaluat or m ust evaluat e your ability to perform the following hands- on practical skills.

Abdom inal exam Post ural vit al signs exam Focused hist ory

Ob j e ct iv e s

CBT/ OTEP 435 is an EMT cont inuing educat ion and recert ificat ion course. Aft er com pleting this course you will be able to:

1. I dentify the location of anatom ical structures in the abdom en. 2. I dentify the types of pain that the hum an body experiences. 3. Describe som e com m on causes of abdom inal pain. 4. Describe how to exam ine the abdom en and inspect and palpate signs and

sym ptom s of inj ury. 5. I dent ify t he correct st eps in perform ing a postural vital signs check. 6. I dentify the proper em ergency m edical care for a patient with abdom inal pain.

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Seat t le/ King Count y EMS

CBT/OTEP 435 ? Abdominal Pain

Term s

acut e abdom en -- A sudden onset of severe abdom inal pain.

colic -- A severe int erm it t ent , cram ping pain.

fallopian tube -- Hollow tube that transports the ovum (fem ale egg) from the ovary to the uterus.

guarding -- A spasm of the m uscles to m inim ize m otion and agitation of pain.

N OT SI CK -- A pat ient who appears physiologically st able as indicat ed by adequat e respirat ions, pulse, m ent al st at us, skin signs and an appropriat e body posit ion. Ot her t erm s t hat m ean NOT SI CK include non- crit ical, non- urgent or st able pat ient .

peritoneum -- A m em branous sac that lines the abdom inal cavity.

SI CK -- A pat ient who appears physiologically unst able as indicat ed by respirat ions, pulse, m ent al st at us, skin signs and body posit ion. Ot her t erm s t hat m ean SI CK include crit ical, urgent or unst able.

sust ained t achycardia -- A persist ent heart rat e of 100 or great er caused by a clinical condition such as hypoxia or shock. I t is an om inous sign of im pending shock.

syn cope -- Faint ing.

tachypnea -- A rapid breathing rate.

New Terms

cholecystitis -- I nflam m ation of the gall bladder.

e t iology -- The cause or origin of a disease or disorder.

e piga st r ium -- The upper cent ral region of t he abdom en. I t is locat ed bet ween t he costal m argins and the subcostal plane. I t is one of the nine anatom ical regions of the abdom en.

hem at em esis -- Vom iting of blood ( hem a = blood + em esis = vom it ) .

he m a t oche zia -- The passage of bloody st ools.

h e r n ia -- Prot rusion of an organ or t issue t hrough an opening in it s surrounding walls, especially in the abdom inal or groin region.

m e le n a -- Abnorm al, black, t arry st ools caused by gast roint est inal ( GI ) bleeding. Melena is usually caused by upper GI bleeding since digest ed blood is dark and t arry in ch ar act er .

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Seat t le/ King Co. EMS

CBT/OTEP 435 ? Abdominal Pain

ort hostat ic hypot ension -- A sudden fall in blood pressure that occurs when a person sits or stands up.

r e t r ope r it one um -- This is t he area direct ly behind t he perit oneum .

va gus ne rve -- The prim ary nerve of t he parasym pat het ic nervous syst em t hat supplies nerve fibers to the pharynx, larynx, trachea, diaphragm , lungs, heart, esophagus and the intestines -- also called t he t ent h cranial nerve.

varices -- Dilated veins.

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CBT/OTEP 435 ? Abdominal Pain

Anatom y

The abdom en is t he largest cavit y in t he body. The diaphragm separat es t he abdom inal cavit y from t he chest cavit y. Most of t he abdom inal organs are enclosed wit hin a m em brane called t he perit oneum . Those organs behind and out side t he perit oneum include the kidneys, pancreas and the abdom inal aorta.

The Four Abdom inal Quadrants

The abdom en is divided int o four regions or quadrant s, wit h t he um bilicus being t he point where the two lines intersect.

? Righ t u ppe r qua dr a n t ( RUQ) cont ains t he liver, gallbladder and part of t he large intestine.

? Le ft uppe r qu a dr a n t ( LUQ) cont ains t he st om ach, spleen, pancreas and part of the large intestine.

? Righ t low e r qua dr a n t ( RLQ) cont ains t he appendix, sm all int est ine, fallopian tube and ovary.

? Le ft low e r qua dr a nt ( LLQ) cont ains t he sm all and large int est ine, fallopian t ube and ovary.

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