Abdominal

order

1. ss/bsi

2. bystander

3. cc

4. vitals

5. expose and palpate

6. opqrst

7. sick questions

8. lifestyle/general hx

9. sample retrend

10. orthos if needed

ss

Scene size up

1. BSI/SS

2. Number of pt

3. Number of bystanders

4. Obvious life threats

5. Pertinent weather

6. Has ALS been co-dispatched?

7. Bring Primary and Fannies

8. General impression

bystander

1. what’s going on

2. how long has it been going on for

3. any vomit

   • anything unusual about the vomit

4. any unusual

5. sample

cc

1. what’s going on

2. how long

3. what might be happening

4. has anything like this happened before

   1. how does it compare

   2. what did u do last time

5. have u been sick recently

6. around any sick ppl

7. recent rec drugs/alc

vitals

glucose pupils temp

skin bp hr rr spo2

• above 100.4F claytoin with ab pain

• 104F no ab pain

expose palpate

1. lift shirt assess swelling and find navel

2. ask pt to locate pain and start palpating in furthest quadrate

3. palpate in wave-like motion

4. ask for pain when applying and releasing pressure for each quadrant

peritoneal signs and suspected appendicitis

1. distension

2. guarding

3. rigidity

4. tenderness

5. rebound tenderness

1. rebound tenderness in LRQ

all these call clayton

opqrst

debilitating call clayton

sick questions

• prioritize questions based on symptoms

• preface sensitive nature of urine/bowel/uterus

food

1. LOI

2. anyone else eat it

3. allergies

4. new/unusal foods

water

1. how much drank

2. normal?

3. tongue color

4. can you keep water down

nausea

1. are you nauseous

2. when did it start

3. are you feeling better or worst

4. do you feel like wanna throw up

vomit

1. have you vomited

2. how long ago

3. how much

4. redness or coffee grounds

5. anything unusal

6. did u feel better before or after

after this move to private

6=sick and vomit

urine

1. last urination

2. any pain

3. redness

4. unusual

bowel moment

1. last bowl movement

2. any pain

3. blood, coffee grounds, or tarry

4. consistency

5. anything unusual

uterus

1. do you have one

2. do u menstraute

   1. when was first day of last cycle

   2. are ur menstruations usually regular

   3. anything unusal about your most recent period

   4. any associated pain

3. do you use birth control/contraceptives

   1. what type?

      1. if IUD or implant, when was it placed, and complications

   2. any change in brand or dose

   3. taken them recently/regulary/consistently?

   4. any possible side effects

4. any chance of pregnancy

   1. hae you had sex with a sperm producing partner

if… call clayton

• significant blood in vomit, stool, and urine (more than streaks or a teaspoon)

• excessive vomiting

• can’t keep water down and dehydrated

general hx qs

lifestyle

• changes in diet, exercise, stress, and sleep

• recent abdominal surgeries/trauma

sample/retrend

sample, retrent opqrst, vitals

• drug investigation for possible changes in dose/brand during sample

• Medications

  • Prescription? Change in brand/ dose? Taken regularly? 

  • OTC? How much? When? Why did you take it? 

  • Rec drugs? 

  • Alcohol? 

• AGE in sample

orthos/disposition

if release to self

• ALS

  • Fever of 100.4 F with abdominal pain

  • Excessive vomiting

  • Peritoneal signs

    • Includes rebound tenderness and guarding

  • Debilitating pain

    • The pt states that they cannot go about their normal day 

  • Significant blood in vomit or stool or urine

    • Teaspoon or more of bright red (more than streaks) 

  • Inability to keep down fluids and dehydrated

• WUPD/ SHS

  • Inability to keep down fluid but not dehydrated

  • Streaking blood in stool or vomit 

  • Pt is concerned

• Release to self

  • Condition improving

  • Pt no longer concerned 

• Contact Field Director after call if: 

  • You get a temp of 101.5F at any point and you release to self, or pt stated that they had a fever of 101.5F before calling at any point.