So I have decided that because repetition is a useful tool for anyone entering the prehospital field, I would put together a series that follows the BLS PCS (Ontario Canada) Standards. This looks at key standards in a step by step list of things you need to do. As a disclaimer, these notes are not a substitute for following the provincial standard and you need to follow those written guidelines in order to avoid malpractice. What this series is, is a plain english, easy to remember guide to the protocols.
Abdominal Pain (non-traumatic):
Assess the scene for any potential causes or life threats during EMCAP.
Upon approaching the patient, form a general impression, noting LOA, skin colour/condition, positioning, and respiratory effort.
Upon patient contact, for the responsive patient, perform the primary survey, noting LOA, airway patency, respiratory rate, depth, and effort, and assess pulse. Mae corrections required prior to moving on. In the unresponsive patient perform CAB, and if pulseless, initiate cardiac arrest protocol.
Obtain the history of present illness, Phx, Medications, allergies, and last ins and outs.
Collect vital signs and perform a physical assessment of the abdomen, palpating all 4 quadrants (unless a pulsatile mass is noted), for tenderness, asymmetry, rigidity, distension, or masses. Observe for discolouration, or scars.
If Vomiting has occurred, assess lung sounds through auscultation to rule out aspiration.
If AAA is suspected, assess distal pulses, and lower limb CSM.
If pain originates above the umbilicus, consider 12-lead ECG acquisition to assess for potential cardiac causes.
Consider analgesics if appropriate, and antiemetic if vomiting is present.
Perform additional treatments based upon Ddx.
Transport with appropriate priority and CTAS, continuing to assess the patient en-route.
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