NON-TRAUMATIC
ABDOMINAL EMERGENCIES
INTRODUCTION
Optimal patient care requires that the EMT-I understand pathophysiology and principles of management of the patient with a non-traumatic abdominal emergency. The following topics
will be discussed during this lesson:
· Anatomy and physiology of the abdomen.
· Assessment of the abdomen.
· Abdominal pathophysiology.
· Prehospital care of patients with abdominal pain.
At the end of this lesson the participants will be able to:
1. Identify the four quadrants of the abdominal cavity.
2. Name major organs located in each of the four quadrants.
3. State what should be included in the initial assessment and detailed history and physical exam assessment.
4. Describe the pertinent questions to be included in the history assessment of a patient with abdominal pain.
5. State the signs/symptoms and field treatment of different GI emergencies.
6 Recognize the signs/symptoms of different GU emergencies.
7. Identify signs/symptoms of reproductive emergencies including field treatment.
8. State the general principles of field treatment for the patient experiencing abdominal pain.
9. Discuss the EMT-I responsibilities when dealing with a patient experiencing abdominal
pain.
10. Discuss transport decisions for non-traumatic abdominal emergencies.
SKILLS
Orthostatic vital signs
KEY VOCABULARY
The
following terms will be used during this lesson:
· Abdominal Aneurysm - tear in between layers of the aorta creating a balloon
effect which may rupture causing massive bleeding
· Anorexia - lack or loss of appetite
· Anemia - a decrease in blood hemoglobin
· Appendicitis - inflammation/infection of the appendix
· Diverticula - small pouches on the colon from degeneration of the muscle layer
· Esophageal Varices - enlarged (dilated) blood vessels in the esophagus which may
be easily ruptured causing severe bleeding; usually caused by liver disease
· Hematemesis - vomiting blood
· Hematuria - blood in the urine
· Hemorrhoid - enlarged blood vessels near the anus
· L.M.P. - abbreviation for last menstrual period
· Melena - black, tar like feces caused by gastrointestinal bleeding
· N.P.O. - an abbreviation that means nothing by mouth
· Peritoneum - a fibrous sac surrounding the abdominal cavity
· Peritonitis - an inflammation of the peritoneum
· Periumbilical - area surrounding the umbilicus.
· Ulcer - erosion of the stomach or intestinal lining which causes pain and/or
bleeding
KEY CONCEPTS
The following section provides information and space for taking notes on the key concepts discussed by the instructor.
ABDOMINAL ANATOMY
Boundaries of the Abdomen
|
· Diaphragm · Anterior abdominal wall · Pelvic skeletal structure · Vertebral column · Muscles of the abdomen and flank |
Surface Anatomy
|
· Upper quadrants (2) o Right and left o Upper border - xiphoid · Lower quadrants o Right and left (2) o Lower border - symphysis pubis The point of intersection is the umbilicus. |
Left Upper Quadrant
|
· Spleen · Tail of the pancreas · Stomach · Left kidney · Part of the colon |
Right Upper Quadrant
|
· Liver · Gall bladder · Head of the pancreas · Right kidney · Part of the duodenum · Part of the colon |
|
|
Left Lower Quadrant
|
· Small intestines · Descending colon · Left ovary and fallopian tubes |
Right Lower Quadrant
|
· Appendix · Ascending colon · Small intestine · Right ovary and fallopian tube |
Structure and Function of the Gastrointestinal System
|
· Function: The gastrointestinal system is responsible for converting raw food into an energy form that the body can use. · Organs of digestion: o Oral cavity o Esophagus o Intestines · Accessory Organs of Digestion o Salivary glands o Teeth o Liver o Gallbladder o Pancreas o Appendix |
INITIAL ASSESSMENT AND FOCUSED HISTORY AND DETAILED PHYSICAL
EXAMINATION FOR NON-TRAUMATIC ABDOMINAL EMERGENCIES
|
1). Assess environment: (may need to manipulate the environment) · Safety of rescuers and environment
|
3).
Breathing: assess the
rate and quality of respirations 5). Skin
signs: assess color,
temperature and moisture 7). Determine chief complaint: 4).
Circulation: palpate for
pulse noting rate/rhythm/quality 2).
Airway: determine
responsiveness and patency of airway
FOCUSED HISTORY AND DETAILED PHYSICAL EXAMINATION
6). Assess
Neurological Status: 3). Vital Signs 1). Elicit history of chief complaint or
problem (PQRST) 4). Special Questions Ask questions specific to chief complaint: 2). Elicit personal history (HAM) 5). Pertinent Body Check: