Bonner County EMS System Patient Care Treatment Guidelines-Medical Emergencies & OB/GYNMedical Emergency Guidelines: Abdominal Pain -7060

ABDOMINAL PAINPatient Complaint of Abdominal Pain in the Absence of Trauma

History Age Past medical/ surgical history Medications Onset Palliation/ Provocation Quality (crampy, constant, sharp,

dull) Region/Radiation/Referred Pain Severity (1-10) Time (duration, repetition) Fever Last meal eaten, Last bowel

movement Menstrual history / possible

pregnancy

Signs and Symptoms Pain (location/migration) Tenderness Nausea, vomiting Diarrhea, bloody stool Dysuria Constipation Vaginal bleeding or discharge Pregnancy Associated symptoms: Fever,

headache, weakness, malaise, myalgias, cough, mental status changes, rash

ASSESSMENT Pneumonia, Pulmonary

embolus Liver (hepatitis, CHF) Peptic ulcer disease/

Gastritis Gallbladder/ Cholecystitis Myocardial infarction Pancreatitis, Appendicitis Kidney stones, Diverticulitis Abdominal aneurysm Bladder or prostate disorder Pelvic (PID, Ectopic

Pregnancy, ovarian cyst) Spleen enlargement Bowel obstruction Gastroenteritis (Infectious)

TREATMENT GUIDELINESR-EMR E-EMT A-AEMT P-PARAMEDIC **M-Medical Control

*****Higher level of providers are responsible for lower level treatments***

Initial Patient Contact (2000). Infection Control (1031). Oxygen Administration as indicated (9000). Temperature measurement (9047). Do not give patient anything by mouth.

R Consider Orthostatic Blood Pressure Measurement. Transport to receiving facility as indicated with ALS intercept if patient is

severely ill.E

Establish IV with NS, draw labs; do not delay transport for IV access.2

If orthostatic, administer bolus of NS, 20 cc/kg. Check breath sounds following bolus.2

A ALS required for Hypotension, gravid patient with other signs or

symptoms, possible cardiac disease. Gentle palpation of abdomen for masses, pulsation, rigidity, guarding, and listen

for bowel sounds. Consider Administration of Odansetron 4mg IV for nausea and vomiting. Go to appropriate Guidelines for other specific complaints.

P ** Call Medical Control for severe Hypotension, suspected ectopic pregnancy

and unstable vital signs. ** M2EMT providers may perform these procedures if credentialed with the appropriate OM.Pearls:Document the mental status and vital signs prior to administration of anti-emetics.Abdominal pain in women of childbearing age should be treated as an ectopic pregnancy until proven otherwise.

_______________________________________________________________________________________________________________________________________BCEMS Medical DirectorEffective: 04/01/14 final 5/9/2023 page 1 of 2

Bonner County EMS System Patient Care Treatment Guidelines-Medical Emergencies & OB/GYNMedical Emergency Guidelines: Abdominal Pain -7060

Antacids should be avoided in patients with renal disease.The diagnosis of aortic aneurysm or cardiac disease should be considered in patients over 50.Appendicitis may present with vague, peri-umbilical pain which migrates to the RLQ over time.

_______________________________________________________________________________________________________________________________________BCEMS Medical DirectorEffective: 04/01/14 final 5/9/2023 page 2 of 2