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Ch. 19-Acute Abdominal Distress and Related Emergencies

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1 Ch. 19-Acute Abdominal Distress and Related Emergencies

2 19.1 Assessment Determine whether the victim is restless or quiet, and whether movement causes pain. Look to see whether the abdomen is bloated (distended). Confirm the abnormal contour with the victim. Feel the abdomen very gently to determine whether it is tense or soft (see Figure 19–3) and whether any masses are present; never press on a pulsating abdominal mass. If you know that a specific quadrant is causing the pain or the majority of the pain, examine that quadrant last. Determine whether the abdomen is tender when touched and whether the victim can relax the abdominal wall upon request. Note any abdominal guarding. Determine the location and quadrant of the pain. 2

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4 PROGRESS CHECK 1. For assessment purposes, the abdomen is divided into four ____________. (sections/quadrants/areas) 2. In assessing a victim with abdominal distress, your number-one priority is to look for signs of ____________. (appendicitis/internal bleeding/shock) 3. If you know what section of the abdomen is causing pain, feel that section ____________. (first/last/gently) 4

5 19.2 Signs and Symptoms Abdominal pain (local or widespread)
Cramplike pain that occurs in waves (colicky pain) Local or widespread abdominal tenderness Anxiety and reluctance to move Rapid, shallow breathing Rapid pulse Tense, often bloated abdomen Signs of internal bleeding: vomiting blood (bright red or the consistency of coffee-grounds) or passing blood in the stool (bright red or tarry black) Nausea and/or vomiting Signs of shock Low blood pressure 5

6 PROGRESS CHECK 1. Any severe abdominal pain should be considered ____________. (after the primary survey/an emergency/a treatment priority) 2. A victim of abdominal distress usually appears very ____________. (anxious/fatigued/ill) 3. Colicky pain is a cramplike pain that occurs in ____________. (waves/infants/liver disease victims) 4. A victim of acute abdominal distress often positions himself or herself on the ____________. (back/stomach/side) 6

7 19.3 First Aid Care 1. Secure and maintain the airway; be alert for vomiting and possible aspiration. 2. Position the victim as comfortably as possible, and take steps to prevent shock 3. Comfort and reassure the victim 4. Never give anything by mouth, and never allow the victim to eat or drink anything. Never give the victim medications of any kind, and do not let the victim take medications on his or her own. Never give the victim an enema. 5. Record signs and symptoms, including the victim’s description of the condition, and continue to monitor until emergency help arrives. 7

8 PROGRESS CHECK 1. A goal of first aid care for acute abdominal distress is to ____________. (prevent shock/predict the need for surgery/prevent vomiting) 2. Let the victim choose the most comfortable position unless there are signs of ____________. (internal bleeding/appendicitis/shock) 3. If the victim is nauseated, position the victim on ____________. (the back/the left side/the stomach) 8

9 Ruptured Esophageal Varices
1. Immediately secure an open airway. 2. Position the victim on his or her left side with the face pointed downward to allow drainage of blood and saliva. Maintaining a clear airway is critical to the victim’s survival. 3. Treat for shock. 9

10 Abdominal Aortic Aneurysm
1. Examine the abdomen very gently, if at all; pressure or firm palpation can aggravate the emergency and cause further dissection (bursting) of the artery. 2. Treat the victim for shock and monitor vital signs until emergency personnel arrive. 10

11 Vocabulary Peritonitis- Inflammation of the lining of the abdomen
Abdomen- The area of the body between the nipples and the groin Quadrants- sections; the abdomen is divided into four quadrants Esophageal varices- Bulging, engorged, weakened blood vessels in the lining of the wall of the lower one-third of the esophagus Abdominal aortic aneurysm- A section of the wall of the aorta in the abdomen that weakens, dilates, and eventually ruptures Pallor- Paleness Colicky pain- Cramplike pain that occurs in waves 11

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