Serial killers: Abdominal pain

Identifying the conditions that can kill people emergently when they call 911 with abdominal pain


The MCHD Paramedic Podcast “Serial Killer Series” targets the most common chief complaints and the killer diagnoses that you should always consider. Find more episodes here.

We often start with a diagnosis and teach from there – for example, CHF, asthma and COPD are all podcast topics we have previously tackled. But, how to get to the final diagnosis is often a process that all levels of emergency providers struggle with.

To go from undifferentiated abdominal pain with unstable vitals to then filter to an organized differential is often quite challenging. As we discussed in our initial chest pain episode, we’re not going to spend time with non-emergent/chronic diagnoses, just the ones that are deadly when missed. That’s where we, as emergency providers, must begin. Today we’re going to focus on acute abdominal pain.

We’ll discuss the things that can kill people emergently when they call 911 with abdominal pain, and where to start with:

  • Ruptured AAA
  • Ruptured ectopic pregnancy
  • Ischemia (mesenteric and myocardial)
  • Visceral perforation – peritonitis
  • Torsion (ovarian/testicular)

Listen to next: Serial killers: Acute chest pain

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