Educator, paramedic, and researcher David Page led an interactive and informative session on the prehospital assessment of abdominal pain at the Wisconsin EMS Association Working Together conference in Milwaukee, Wis. Page’s presentation, a combination of slides, videos, case reviews, and practical exercises, taught participants abdominal anatomy and potential sources of pain.
Overview
Page, capitalizing on his interests in educational methodology research, started the session by explaining the importance of note taking to learn and retain knowledge. He then led a review focusing on assessment of the “differential diagnosis of the problems that will kill your patient fast and first.”
Next, he gave an in-depth tour of abdominal anatomy and explored problems associated with each of the abdominal organs. Page’s presentation was fast-paced, informative, and well-balanced for an audience that was a mix of EMTs and paramedics.
Most memorable quotes
“The belly is the big black hole of the body. It includes anything between the nipple line and the umbilicus, including the diaphragm.”
“End-tidal carbon dioxide is the smoke of metabolism.”
Takeaways: abdominal pain assessment
- There are many severe medical problems – acute myocardial infarction, abdominal aortic aneurysm, and pulmonary embolism – that can present as belly pain.
- Don’t stress out trying to determine the specific cause of belly pain. The ED diagnosis for 42 percent of abdominal pain complaints is “unknown.”
- Manage all patients in pain. Distraction works and should be applied to any patient.
- Unexplained hypovolemic shock, when the source and cause is unknown, is most likely caused by abdominal bleeding.
- Patient age and gender correlate with specific diseases. For example, nearly one-third of abdominal pain in 3-to-12-year-old patients is appendicitis.
