1. Lesson 11: Abdominal Illness

2. Objectives
Demonstrate a field assessment for abdominal pain/discomfort
List signs/symptoms of serious abdominal problems
Define and describe treatment of and long term care for stomachache and diarrhea
Describe situations that would require evac versus rapid evac
Describe personal/camp hygiene to help prevent abdominal issues

3. Abdominal Illness Overview
Abdominal pain can be common
May never know source of the problem
When taking SAMPLE history ask about abdominal pain/discomfort
To assess, press gently on four quadrants with fingers flat on abdomen. Start away from the pain
Note results in assessment

4. Checking and Caring for Stomache
Gastritis: inflammation of stomach lining, causes most stomachs
Signs/symptoms
Gradually increasing/widespread discomfort, often worse in lower region
Intermittent cramping
Nausea and vomiting
diarrhea

5. Care for Stomachaches Keep Patient well hydrated
Provide bland diet, if not vomiting
Maintain good hygiene to keep from spreading

6. Caring for Diarrhea
Diarrhea: frequent loose and watery stools, may also have stomachache
Gastroenteritis: mild inflammation of gastrointestinal tract
If mild, have patient drink water or diluted sports drink/non citrus fruit juice
If persistent, requires aggressive electrolyte replacement.
1 teaspoon salt, 8 teaspoons sugar/qt

7. Caring for Diarrhea If patient not vomiting
Feed with rice, grains, bananas, potatoes or other bland items
Avoid fats, dairy products, caffeine, alcohol
OTC medications can be used if available

8. Serious Abdominal Pain
Signs and Symptoms
Fever higher than 102F
Persistent pain for more than 12 hrs
Localized pain, especially if patient guards area
Tenderness, rigidity, swelling
Pain increases with movement, walking, etc
Blood in vomit, feces, or urine
In vomit looks like coffee grounds
In feces may be black like tar
In urine appears light brown to reddish

9. Guidelines for Evacuation
GO SLOW with any person that has persistent abdominal discomfort
GO FAST for any patient with signs/symptoms of serious abdominal pain

10. Preventing Abdominal Pains
Personal and Group Hygiene
Wash hands with soap and water
Don’t eat leftover food unless properly stored
Bury human waste >200 feet from water source
Do not share personal eating utensils
Do not put personal eating utensils in group food pot
Keep kitchen clean, disinfect all pots/utensils prior to using
Disinfect all drinking water

11. Disinfecting Water
Boiling: rolling boil for at least 1 min (longer at higher elevations)
Chemical treatment, as directed for particular treatment
Filtration: removes bacteria, may not get all viruses
Ultraviolet light devices