28d • Paramedic Talk
Abdominal emergencies you HAVE to know
NREMT Mini Lecture: Abdominal Emergencies
Cholecystitis (Gallbladder Inflammation)
Cause
- Gallstones blocking bile flow
Key Findings
- Right upper quadrant (RUQ) pain
- Pain after fatty meals
- Nausea/vomiting
- Pain may radiate to right shoulder
EMS Considerations
- Oxygen if needed
- Pain management
- Transport
NREMT Pearl
RUQ pain after eating = think gallbladder
Appendicitis
Pathophysiology
- Obstruction of appendix → inflammation
Key Findings
- Pain starts periumbilical (visceral)
- Migrates to RLQ (somatic)
- Fever, nausea
Red Flag
- Sudden relief of pain → possible rupture → peritonitis
EMS Considerations
- Monitor for diffuse abdominal pain
- Signs of sepsis or shock
- Rapid transport
NREMT Pearl
Periumbilical → RLQ = appendicitis
Kidney Trauma (Right Flank Pain + Hematuria)
Causes
- Blunt trauma (MVC, falls)
Key Findings
- Flank pain
- Blood in urine (hematuria)
- Possible bruising to flank
EMS Considerations
- Suspect internal bleeding
- Monitor for shock
- Rapid transport
NREMT Pearl
Flank pain + hematuria = renal injury until proven otherwise
Peptic Ulcer Disease (PUD) & Upper GI Bleed
Cause
- Breakdown of stomach lining (acid, H. pylori, NSAIDs)
Key Findings
- Burning epigastric pain
- Hematemesis (vomiting blood)
- Melena (black tarry stool)
EMS Concerns
- Hypovolemic shock
- Pale, tachycardic, hypotensive
EMS Treatment
- Oxygen
- IV access / fluids
- Rapid transport
NREMT Pearl
Upper GI bleed = coffee-ground emesis or black stools
Ulcerative Colitis
Pathophysiology
- Chronic inflammatory bowel disease
- Affects the colon
Key Findings
- Bloody diarrhea
- Abdominal pain
- Weight loss
- Chronic condition with flare-ups
EMS Considerations
- Risk for dehydration
- Monitor for electrolyte imbalance
- Supportive care
NREMT Pearl
Ulcerative colitis = chronic + bloody diarrhea
Rapid Review
Cholecystitis
- RUQ pain after fatty food
Appendicitis
- Periumbilical → RLQ
Kidney Trauma
- Flank pain + hematuria
PUD / GI Bleed
- Epigastric pain + blood (vomit or stool)
Ulcerative Colitis
- Chronic bloody diarrhea
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Abdominal emergencies you HAVE to know
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