Transcript 16 - Philadelphia University

Chapter 19
First Aid for Colleges
and Universities
10 Edition
Acute Abdominal
Distress and
Related
Emergencies
Slide Presentation prepared by
Randall Benner, M.Ed., NREMT-P
© 2012 Pearson Education, Inc.
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.
© 2012 Pearson Education, Inc.
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.
© 2012 Pearson Education, Inc.
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.
© 2012 Pearson Education, Inc.
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.
© 2012 Pearson Education, Inc.
Abdominal Quadrants
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Example of Guarding
• A victim who guards their abdominal area
provides important clues to the location
and extent of pain.
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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.
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Abdominal Pain: Signs and Symptoms
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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
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Sources of Acute Abdominal Distress
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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.
© 2012 Pearson Education, Inc.
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.
© 2012 Pearson Education, Inc.
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.
© 2012 Pearson Education, Inc.
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
© 2012 Pearson Education, Inc.
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.
© 2012 Pearson Education, Inc.
Special Considerations
• 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
© 2012 Pearson Education, Inc.
Special Considerations
• 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.
© 2012 Pearson Education, Inc.
Special Considerations
• 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
© 2012 Pearson Education, Inc.
Special Considerations
• 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
© 2012 Pearson Education, Inc.
Special Considerations
• 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.
© 2012 Pearson Education, Inc.
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.
© 2012 Pearson Education, Inc.