Abdominal pain is a common presentation, delays in diagnosis and management can complicate the patient outcome.
Achieving the balance between safe and expedient assessment versus delay and over investigation is the key in managing abdominal pain presentations.
History Red Flags
Immunocompromised (e.g. HIV, chronic steroid treatment, renal failure, transplant patients and cancer patients on chemotherapy)
Previous abdominal surgery
Cardiac disease (AF, IHD)
Nature of pain
Severe at onset
Signs of shock
ATS recommendations: Patients with any of the RED flags listed above, minimum ATS category of 2. Patients with any of the other factors listed above should be allocated to a mimimum ATS category of 3.
Early analgesia is important
Nurse initiated pathway: Example courtesy of Nepean Hospital.
An example of a disposition pathway is suggested. (Dr Rod Bishop, Nepean Hospital)
We present some clinical pathways which may be of use in guiding your practice and useful current links which will drive further searches.
Paediatric Abdominal Emergencies
This clinical tool deals with surgical abdominal emergencies in adults. Useful resources for management of paediatric abdominal emergencies can be found here.