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A "cute" Abdomen
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An acute abdomen may indicate any of the following: Peritonitis, Diverticulitis, Cholecyctitis, Appendicitis, Peptic Ulcer, Duodenal Ulcer, Pancreatitis, Aortic Aneurysm, Cystitis, Kidney Infection, Kidney Stone. (In women) Pelvic Inflammatory Disease (PID), Ectopic Pregnancy, and Other Gynecological Problems. And the list goes on...
It's characteristics may include localized or diffuse pain, the patient may or may not be guarding, it may or may not include: referred pain, constipation, diarrhea, nausea, vomiting, abdominal distention, fever, or rebound tenderness. It will in most cases lead to tachycardia and hypotension.
The talent, and information necessary, to properly diagnosis the cause of an acute abdomen, goes well beyond the ability of most (if not all) EMT-B's and beyond the ability of some (if not most) Paramedics.
We are in total agreement with the editors of Emergency - Care and Transportation of the Sick and Injured when it comes to emergency medical care of the Acute Abdomen, and have reproduced their suggestions here, exactly as they appear in the Eighth Edition:
Do not attempt to diagnose the cause of the acute abdomen.
Clear and maintain the airway.
Anticipate vomiting.
Administer Oxygen.
Do not give the patient anything by mouth. Food or fluid will only aggravate many of the symptoms, since intestinal paralysis will prevent it from passing out of the stomach. The presence of food in the stomach will make any emergency surgery more dangerous.
Document all pertinent information: Onset, Provocation, Quality, Radiation, Severity, Time and treatment (OPQRST.) Note the presence of abdominal tenderness, distention, or guarding.
Anticipate the development of hypovolemic shock. Treat the patient for shock when it is evident.
Make the patient as comfortable as possible for transport. Conserve body heat with blankets, as needed.
Monitor vital signs; these may change quickly.
There is nothing that we could add that would increase the substantive value of this section. Our only additional suggestion would be to guard against being lulled into the misguided interpretation that "it's only a stomach-ache."
