First Aid for Colleges and Universities 10 Edition Chapter 19 © 2012 Pearson Education, Inc. Acute Abdominal Distress and Related Emergencies Slide Presentation

First Aid for Colleges and Universities

10 Edition

Chapter 19

© 2012 Pearson Education, Inc.

Acute Abdominal Distress and Related Emergencies

Slide Presentation prepared by

Randall Benner, M.Ed., NREMT-P

Learning Objectives

• Describe the special assessment procedures used for a victim of abdominal distress.

• List the signs and symptoms of abdominal distress.

• Describe and demonstrate general first aid care for acute abdominal distress.

• List the signs and symptoms of ruptured esophageal varices.


Learning Objectives

• Describe and demonstrate the first aid care of a victim with ruptured esophageal varices.

• List the signs and symptoms of ruptured abdominal aortic aneurysm.

• Describe and demonstrate the first aid care for a victim with ruptured abdominal aortic aneurysm.


Introduction

• Abdominal pain may originate from one of multiple body systems present in the abdominal cavity.

• Abdominal distress should be considered life threatening until proven otherwise.

• The First Aider’s ability to recognize and treat abdominal pain can improve outcomes.


Abdominal Assessment

• Abdomen is the entire area between nipples and the groin.

• Divided into four quadrants– Upper right quadrant (URQ)– Upper left quadrant (ULQ)– Lower right quadrant (LRQ)– Lower left quadrant (LLQ)

• Observe and palpate to determine location and quadrant of pain.


Abdominal Quadrants


Example of Guarding


• A victim who guards their abdominal area provides important clues to the location and extent of pain.

Abdominal Assessment

• Determine if patient is restless or quiet.• Assess for pain with movement.• Confirm any abnormal contours in the abdominal

area.• Assess for abdominal bloating or distention.• Palpate the four quadrants for irregularities.• Assess for guarding or rigidity.• Determine the location and extent of pain.


Abdominal Pain: Signs and Symptoms

• Pain can be local or widespread• Abdominal tenderness• Rapid breathing and pulse• Nausea and/or vomiting• Possible drop in blood pressure• Abdominal distention• Signs of shock (internal bleeding)• Unusual bladder or bowel function, including

black or bloody stools



Sources of Acute Abdominal Distress

Abdominal Pain: First Aid Care

• Primary goal is to prevent life-threatening complications.

• Take standard precautions, activate EMS.• Assess, secure, and maintain the airway.• Provide ventilations if needed.• Position the patient comfortably.• Treat for shock (keep warm, elevate legs).• Never give anything by mouth.• Reassess and comfort victim until EMS arrives.


Nausea and Vomiting

• Can result from multiple causes• First aid care for nausea/vomiting

– Take precautions, activate EMS if acute. – Place victim on side to help with vomiting.– If no acute illness, try giving clear fluids by mouth.– Do not give meat or dairy products for 48 hrs after

vomiting stops.– Do not allow consumption of solid food for 48 hours or

until hunger returns.


Diarrhea

• Passage of loose, watery stools• Commonly caused by a GI infection• May present with severe dehydration• First aid care for diarrhea:

– Drink 8–10 glasses of clear fluid per day.– Progress from fluids to mild foods (soup or gelatin).– After mild foods, progress to BRAT diet (bananas,

rice, applesauce, toast).– Consider OTC anti-diarrheal medications.


Diarrhea

• Seek medical attention if any of the following are present:– Blood in the stool (fresh or digested)– Mucus in the stool (slimy covering)– Victim cannot stand without fainting– Dehydration– Concurrent severe abdominal pain– Concurrent fever– Diarrhea does not resolve in 24 hours


Special Considerations

• Ruptured esophageal varices– Bulging, engorged, weakened blood vessels in

esophagus– Common to heavy alcohol drinkers, liver disease, liver

dysfunction, enlarged liver, victims with jaundice

• Varices can lead to painless GI bleeding, which is often fatal without treatment.



• Ruptured esophageal varices symptoms– Vomiting profuse amounts of blood– Blood welling up in the back of the throat– Abdominal pain (without tenderness) – Signs of shock and pallor– Possible respiratory distress



• Ruptured esophageal varices treatment– Take standard precautions and activate EMS.– Immediately secure an open airway.– Position patient on left side with face turned down for

continuous blood drainage.– Treat for shock (keep warm, elevate legs).– Reassess and comfort patient until EMS arrives.



• Abdominal aortic aneurysm (AAA)– Vascular walls of descending aorta weakens– Eventually weakened region will rupture– Patient rapidly bleeds into abdominal cavity– One of the most lethal causes of abdominal pain– Most common in patients with atherosclerosis– Two out of ten men over 50 years of age have

abdominal aneurysms



• Abdominal aortic aneurysm (AAA) symptoms– Sudden, severe pain in the abdomen or back– Possible radiation to lower back, flank, or pelvis– Possible nausea and vomiting– Mottled abdominal skin– Decreased or absent pulses in the groin and foot– Possible pulsating mass in the abdomen– With rupture, abdomen may become distended



• Abdominal aortic aneurysm (AAA) treatment– Activate EMS.– Examine the abdomen very gently.– Do not use any hard pressure during palpation.– Assess and manage the airway and breathing

components if needed.– Treat the patient for shock.– Monitor the patient until EMS arrives.


Summary

• Primary goal with abdominal pain is to provide first aid, not determine the source of pain.

• Any severe abdominal pain should be considered an emergency, and EMS should be activated.


Documents

First Aid for Colleges and Universities 10 Edition Chapter 19 © 2012 Pearson Education, Inc. Acute Abdominal Distress and Related Emergencies Slide Presentation