By Junaid Asghar M Med, FAFP Consultant Adult Emergency Medicine. King Faisal Specialist Hospital & Research Centre- Riyadh- KSA
|
|
|
- Wilfrid Young
- 5 years ago
- Views:
Transcription
1 By Junaid Asghar M Med, FAFP Consultant Adult Emergency Medicine King Faisal Specialist Hospital & Research Centre- Riyadh- KSA
2 Case No 1 A VIP patient brings his 21 years son in EM with the complaints of diarrhea & vomiting since yesterday. He complains of abdominal pains also which are becoming worst since this morning. He mentions 6 episodes of vomiting & passed 4 loose stools since last night. He ate outside in a hotel yesterday with his friend & none of them have fallen sick except him. The father has a concern that it might be appendicitis & demanding you to do Lazim CT on him. What will be your approach to this patient?
3 Case No 2 A 19 yrs old male comes to you in EM with the H/O Lt testicular Pain since this morning. He mentions about his recent visit to Thailand & highlights some of his sexual activities there to you. On examination the cremasteric reflex is negative & the testicle is swollen & tender. What next you will do?
4 Case No 3 On Thursday morning a 6 yrs old male child in brought in ER by a divorcee mother with complaints of hematuria for 2 days. She gives history of fever, abdominal pain & vomiting. On examination: The child looks quiet. Vitally stable. Urinalysis reveals +4 blood only. How will you approach? Polle s
5 Case No 4 On a busy EM evening shift you are about to finish your shift. An old man 68 years old man is shouting with constant abdominal pain since this morning. He is just demanding pain medication & wants to go home. He is vitally stable with the BP 145/78, pulse 68/min, RR 14 & SpO2 of 95% On examination: A thin guy with abdominal pulsations slightly tender around umblicus. He is known to have NIDDM, HPT & dyslipidemia. Smokes 1 pack of cigarettes a day. How will you handle him?
6 Case No 5 A 71 yr old male presents in ER with the history of severe Rt flank pain which started 2 hrs ago. He denies any previous such an episode of pain. Denies BOM or dysuria Known to DM, HPT, dyslidemia, Atrial Fibrillation Vitally Temp 37.1oC, BP 168/89, pulse 104 & SpO2 of 94% Urinalysis reveals +2 blood +1 Proteins. How will you manage this patient?
7 By Junaid Asghar M Med, FAFP Consultant Adult Emergency Medicine King Faisal Specialist Hospital & Research Centre- Riyadh- KSA
8 Anatomy of a male abdomen
9 Male pelvic anatomy
10 Female abdomen anatomy
11 Female pelvic anatomy
12 The different quadrants
13 DefiniDon of acute abdomen An acute intra- abdominal condition of abrupt onset, usually associated with pain due to inflammation, perforation, obstruction, infarction or rupture of abdominal organs, and usually requiring emergency intervention. Called also surgical abdomen. It is usually accompanied by vomiting or diarrhea or both of them.
14 Causes of acute abdomen a. Inflammatory b. Mechanical c. Neoplastic d. Vascular e. Congenital defects- duodenal atresia, omphalocele &diaphragmatic hernia f. Traumatic
15 1- Immediate Management of life threatening problems Patients appearance Evaluate responsiveness Assess ABC Record & review vitals Assess perfusion to brain & extremities Quick clinical examination of abdomen Rectal examination earlier than later
16 1- Immediate Management of life threatening problems Caution: Some pains are of non abdominal in origin like MI, PE, pneumonia, DKA & glaucoma. Identify candidate who require immediate surgery & who are hemodynamically. Start stabilizing the patient immediately & aggressively. Do not delay surgical consult if GIB, Leaking AAA & board like rigidity. Early decision making
17 Treat shock Insert 2 IV catheters 16 Obtain blood samples Crystalloids IV with boluses & see response O2 inhalation Foley s catheter ABGs NG Tube EKG Antibiotics
18 NEVER FORGET Persistent shock despite initial aggressive resuscitation in acute abdomen warrants immediate laprotomy. Prepare the patient for OR. Get the surgeon ready to operate.
19 2- Further evaluadon of padent with abdominal pain History Physical Examination Laboratory Examination Radiological Examination
20
21 History Once the patient is stabilized take detailed history Mode of Onset of pain: a) Abrupt onset- Severe pain at onset vascular accident or rupture of hollow viscous. Moderate that worsens over time like acute pancreatitis, mesenteric thrombosis or small bowel strangulation
22 History b) Gradual onset: Slowly worsening like appendicitis, incarcerated hernia & diverticulitis Character of pain: a) Severe pain: Renal colic, biliary colic, MI, rupture AAA, acute pancreatitis, peritonitis or perforation of hollow viscous b) Dull Pain: Appendicitis & diverticulitis
23 History c) Intermittent pain: crampy & decresendo like in mechanical Int obs d) Absence of pain: like gas stoppage in old people or like retrocecal appendicitis Location of pain: Radiation of pain: Shoulder, peri- umbilcal, radiating from flank
24 History Fever & rigors Nausea & vomiting Anorexia Diarrhea Constipation Urethral discharge BOM or dysuria PV discharge LMP
25 Physical ExaminaDon Inspection Palpation Auscultation Percussion Special signs like iliopsoas, obtuator, Rovsing, Murphy s & Macburnys Pelvic & rectal examination
26 Laboratory ExaminaDon CBCD Aymlase or Lipase Hepatic & Cardiac Enzymes Real profile with urea Pregnancy test Coagulation profiles if indicated EKG, Peritoneal fluid
27 Radiological ExaminaDon KUB Abdominal acute series X Rays with contrast US Angiography? CT MRI
28
29 AddiDonal Measurements for the management of Ac Abdomen Repeated Examination IV Fluids Pain relief IV Paracetamol? IV NSAIDs or IM? Narcotics? Emesis control Antimicrobials Surgical consult
30 Management of specific disorders causing acute abdomen 1- Intestinal 2- Hepatobiliay disorders + Ac Pancreatitis 3- Vascular disorders 4- Urinary disorders 5- Gynaecological disorders 6- Primary peritonitis 7- Retroperitoneal hemorrhage 8- Abd pain non amenable to surgery
31 1- IntesDnal disorders Appendicitis CT- Surgery Intestinal Obstruction- AFLs- NGT- IV Perforated Peptic Ulcer- Air UD- CT- IV- Antib Bowel perforation- rigid- fever- shock- Sur Diverticulitis- hem+stool- CT- IVF+Antib Intestinal strangulation- Shock+dis+CT- Sur Gastroenteritis Rx- IVF, Labs Inflammatory bowel disease Shocked- CT- B in S Incarcerated hernias
32 2- Hepatobiliay disorders + Ac PancreaDDs Biliary Colic- Rx elective CYSTCTMY Acute cholecystitis- NPO- US- HIDA scan Acute suppurative cholingitis NG- Folys- GS Hepatic abscess- Admit+CT+drainage Hepatitis Labs INR, IVF? SBP- Ascitis tap+cbcd Acute pancreatitis- Lipase+GI+Admit
33 3- Vascular disorders Ruptured Aortic Aneurysm IVI+OR+Labs Ischemic Colitis- sigmoidoscopy- IVF- Admit Mesenteric Ischemia- Treat Shock IV AntiB Rupture of spleen- IVline- FAST- CT Admit Splenic Infarction- Hospitalise pain control
34 4- Urinary disorders Renal colic- KUB?- CT- Pain control- consult Pyelonephritis- IVF- AntiB- Adm? Renal Infarction- Analgesi- IVF- Anti Co
35 5- Gynaecological disorders Ectopic pregnancy with rupture Acute salpingitis - PID Ruptured ovarian cyst- Peg Test- Rx Ovarian torsion- Admit Endometriosis- Rx
36 In males Epidydmorchitis Urtheritis
37 6- Primary peritonids Secondry to traumatic fecal soilage in a patient with ascites- bacterial peritonitis
38 7- Retroperitoneal hemorrhage Rare but may be present in patient who are on Warfarin In trauma patients
39 8- Abd pain non amenable to surgical abdomen Poisoning Familial Mediterranean Fever FMF DKA Tertiary syphilis Pre eruptive Zoster
40
41 Solid organs Liver Spleen Kidneys Pancreas
42 Hollow Organs Stomach Intestines Bladder
43 Which quadrant is it in? stomach liver spleen Intestine kidney bladder appendix
44 Types on injuries Closed injury (blunt) Open injury (penetrating)
45 Symptoms & Signs Mechanism of Injury Nausea & vomiting Pain Tenderness on palpation Tachycardia- hypotension Shock Bruising Distended or rigid abdomen
46 The Physical Exam Determine type of injury Observe for distention Palpate Check all 4 quadrants Start away from pain
47 Laboratory ExaminaDon Draw bloods Type & Screen
48 Radiological ExaminaDon Bedside US- FAST Portable X ray CT Scan
49 Treatment of all abdominal injuries Secure two IV lines with wide bore needles High flow O 2 Keep airway clear Treat for shock prn Keep NPO Rapid transport & investigations Supine / shock
50 Care for PenetraDng Injuries Check for exit wounds. Dry sterile dressing Bulky dressing for impaled object
51 Abdominal EvisceraDon Internal organs or fat protrude through the open wound. Do not try to re introduce them back. Cover with moist gauze & apply sterile dressing. Keep organs warm and moist. Transport promptly.
ACUTE ABDOMEN. Dr. M Asadi. Surgical Oncology Research Center MUMS. Assistant Professor of General Surgery
ACUTE ABDOMEN Dr. M Asadi Assistant Professor of General Surgery Surgical Oncology Research Center MUMS Definition I. The term Acute Abdomen refers to signs & symptoms of abdominal pain and tenderness,
Abdominal Pain. Luke Donnelly, MD Emergency Medicine
Abdominal Pain Luke Donnelly, MD Emergency Medicine Objectives Approach to abdominal pain Evaluation Critical diagnoses and treatments Abdominal Pain Most Common ER Complaint Broad Differential Can often
Abdomen and Genitalia Injuries. Chapter 28
Abdomen and Genitalia Injuries Chapter 28 Hollow Organs in the Abdominal Cavity Signs of Peritonitis Abdominal pain Tenderness Muscle spasm Diminished bowel sounds Nausea/vomiting Distention Solid Organs
Chapter Goal. Learning Objectives 9/12/2012. Chapter 29. Nontraumatic Abdominal Injuries
Chapter 29 Nontraumatic Abdominal Injuries Chapter Goal Use assessment findings to formulate field impression & implement treatment plan for patients with nontraumatic abdominal pain Learning Objectives
Abdominal & scrotal pain
Abdominal & scrotal pain Junior Teach Emergency Department 1 Created by SR Bruijns 03/11/2010 Objectives Understanding of, and emergency management of Acute abdominal pain Undifferentiated abdominal pain
Muscle spasm Diminished bowel sounds Nausea/vomiting
3 4 5 6 7 8 9 0 Chapter 8: Abdomen and Genitalia Injuries Abdominal Injuries Abdomen is major body cavity extending from to pelvis. Contains organs that make up digestive, urinary, and genitourinary systems.
: Abdominal Emergencies
INTRODUCTION Abdominal complaints are very common in emergency medicine. The specific cause of the abdominal pain can very rarely be determined in the pre-hospital environment, however performing a good
Causes of abdominal pain Doctors in the ED spend lots of time and money diagnosing abdominal pain. They still often do not know the exact cause
1 2 3 What's Going On in There? EMS and Abdominal Pain Kevin McFarlane BSN,RN,CEN,CPEN,EMT Southwest Emergency Education and Consulting What is going on in there Acute Abdomen Sudden onset of pain within
Chapter 32 Gastroenterology General Pathophysiology General Risk Factors for GI emergencies: Excessive Consumption Excessive Smoking Increased
1 2 3 4 5 6 7 Chapter 32 Gastroenterology General Pathophysiology General Risk Factors for GI emergencies: Excessive Consumption Excessive Smoking Increased Ingestion of Caustic Substances Poor Bowel Habits
Chapter 24 - Abdominal_Emergencies
Introduction to Emergency Medical Care 1 OBJECTIVES 24.1 Define key terms introduced in this chapter. 13, 15, 18, 20 22 24.2 Describe the location, structure, and function of the organs in the abdominal
Gastrointestinal Emergencies CEN REVIEW 2017 MARY RALEY, BSN, RN, CEN, TCRN, TNSCC
Gastrointestinal Emergencies CEN REVIEW 2017 MARY RALEY, BSN, RN, CEN, TCRN, TNSCC Gastrointestinal Emergencies is 7% of the CEN A. Acute abdomen B. Bleeding C. Cholecystitis D. Cirrhosis E. Diverticulitis
Gastrointestinal & Genitourinary Emergencies. Lesson Goal. Learning Objectives 9/10/2012
Gastrointestinal & Genitourinary Emergencies Lesson Goal Recognize, assess & provide care to patients with abdominal cavity injuries Learning Objectives Discuss different causes of nontraumatic abdominal
Surgical Education Series
Surgical Education Series The Acute Abdomen Ahmad kachooei, MD MPH Assistant Professor Division of General Surgery Department of Surgery University of Qom Outline Definitions What causes an acute abdomen
SAEMS ABDOMINAL PAIN STANDING ORDER Self-Learning Module
SAEMS ABDOMINAL PAIN STANDING ORDER Self-Learning Module Dawn Daniels Tucson Medical Center January 2016 PURPOSE This SAEMS Standing Order Training Module has been developed to serve as a template for
2. Blunt abdominal Trauma
Abdominal Trauma 1. Evaluation and management depends on: a. Mechanism (Blunt versus Penetrating) b. Injury complex in addition to abdomen c. Haemodynamic stability assessment: i. Classically patient s
12 Blueprints Q&A Step 2 Surgery
12 Blueprints Q&A Step 2 Surgery 34. A 40-year-old female has been referred to you for a recent ER and hospital admission, from which she was given a diagnosis of acute diverticulitis. Treatment at that
European Board Examination in Emergency Medicine. Example MCQs.
European Board Examination in Emergency Medicine Example MCQs. The Part A of the EBEEM consists of 120 multiple choice questions (MCQ) which cover the European Curriculum for Emergency Medicine. The following
Always keep it in the differential
Acute Appendicitis Lissa C. Sakata and Lindsey Perea 2 Always keep it in the differential Learning Objectives 1. The learner should be able to describe the etiology of acute appendicitis. 2. The learner
Review. 1. Peritonitis would MOST likely result following injury to the: A. liver. B. spleen. C. kidney. D. stomach.
Chapter 28 Review Review 1. Peritonitis would MOST likely result following injury to the: A. liver. B. spleen. C. kidney. D. stomach. Review Answer: D Rationale: In general, solid organs bleed when injured
Chapter 18 - Gastrointestinal & Urologic Emergencies
1 2 3 4 5 6 7 8 Chapter 18 Gastrointestinal and Urologic National EMS Education Standard Competencies (1 of 4) Medicine Applies fundamental knowledge to provide basic emergency care and transportation
GENERAL SURGERY FOR SMART PEOPLE JOE NOLD MD, FACS WICHITA SURGICAL SPECIALISTS
GENERAL SURGERY FOR SMART PEOPLE JOE NOLD MD, FACS WICHITA SURGICAL SPECIALISTS CONFLICTS/DECLARATIONS I have no financial conflicts or declarations I AM always willing to see a consult for you TEXT TOPICS
Role of imaging in the evaluation of the acute abdomen
Prof. András Palkó MD, PhD Role of imaging in the evaluation of the acute abdomen Faculty of General Medicine University of Szeged Hungary 1 Definition Sudden onset of severe symptoms requiring emergency
Introduction to Evidence Based Medicine:
Introduction to Evidence Based Medicine: General Abdominal Examination o Inspection Cullen s sign and Grey Turner s sign are indications of intraperitoneal or retroperitoneal hemorrhage. Traditionally,
Acute Abdomen. Nirav Patel MD, FACS Banner University Medical Center - Phoenix
Acute Abdomen Nirav Patel MD, FACS Banner University Medical Center - Phoenix ? Diffuse periumbilical with localization to RLQ + Nausea, anorexia, fevers - Diarrhea, emesis Exacerbated by movement, bumps
Hernia Advisory Panel. Ethicon, Johnson & Johnson. Funding
Acute Abdomen Andreas M Kluftinger MD FRCSC Kelowna General Hospital Disclosure Hernia Advisory Panel Ethicon, Johnson & Johnson Funding nil, zilch, zippo, nada, zero Objectives Understand the Pathophysiology
General Surgery Service
General Surgery Service Patient Care Goals and Objectives Stomach/Duodenum and Bariatric assessed for a) Obesity surgery b) Treatment of i) Adenocarcinoma of the stomach ii) GIST iii) Carcinoid 2) Optimize
- GI and GU are the main sources of AP, but AP can come from extra- and intraabdominal
Abdominal Pain Karima Sajadi Based on Chapter 27 in Rosen s Emergency Medicine Common CC in ED, but presents lot of challenges for the pts and docs (pts have hard time conveying the nature and quality
UNDERSTANDING X-RAYS: ABDOMINAL IMAGING THE ABDOMEN
UNDERSTANDING X-RAYS: ABDOMINAL IMAGING THE ABDOMEN Radiology Enterprises radiologyenterprises@gmail.com www.radiologyenterprises.com STOMACH AND SMALL BOWEL STOMACH AND SMALL BOWEL Swallowed air is a
An Approach to Abdominal Pain
An Approach to Abdominal Pain objectives Should know the different types of abd pain Is acute or chronic? Hx taking skills with knowing the key questions Important abdominal pain signs A good differential
Small Bowel and Colon Surgery
Small Bowel and Colon Surgery Why Do I Need a Small Bowel Resection? A variety of conditions can damage your small bowel. In severe cases, your doctor may recommend removing part of your small bowel. Conditions
SAEMS ABDOMINAL PAIN STANDING ORDER Self-Learning Module
SAEMS ABDOMINAL PAIN STANDING ORDER Self-Learning Module Mary Ann Matter University Medical Center January 27, 2009 PURPOSE This SAEMS Standing Order Training Module has been developed to serve as a template
USMLE and COMLEX II. CE / CK Review. General Surgery. 1. Northwestern Medical Review
USMLE and COMLEX II CE / CK Review General Surgery 1. Northwestern Medical Review Northwestern Medical Review www.northwesternmedicalreview.com Lansing, Michigan 2014-2015 Acute Abdomen 1. Your patient
General'Surgery'Service'
General'Surgery'Service' Patient Care Goals and Objectives 1)! Stomach/Duodenum and Bariatric 2)! Interpret the results of clinical evaluations (history, physical examination) performed on patients being
58 year old male complaining of 3-week history of increasing epigastric pain
Peptic Ulcer Disease 58 year old male complaining of 3-week history of increasing epigastric pain Has had dyspepsia in the past for which he took Tums, but this is much worse and only partially relieved
Learning Objectives for Rotations in Vascular Surgery Year 3 Basic Clerkship
Learning Objectives for Rotations in Vascular Surgery Year 3 Basic Clerkship CLINICAL PROBLEMS IN VASCULAR SURGERY 1. ABDOMINAL AORTIC ANEURYSM A 70 year old man presents in the emergency department with
NCD for Fecal Occult Blood Test
NCD for Fecal Occult Blood Test Applicable CPT Code(s): 82272 Blood, occult, by peroxidase activity (e.g., guaiac), qualitative, feces, 1-3 simultaneous determinations, performed for other than colorectal
3/22/2011. Inflammatory Bowel Disease. Inflammatory Bowel Disease Objectives: Appendicitis. Lemone and Burke Chapter 26
Inflammatory Bowel Disease Lemone and Burke Chapter 26 Inflammatory Bowel Disease Objectives: Discuss etiology, patho and clinical manifestations of Appendicitis Peritonitis Ulcerative Colitis Crohn s
Perforation of a Duodenal Diverticulum. Elective Student S. C.
Perforation of a Duodenal Diverticulum 2008 4 Elective Student S. C. Case History An elderly male presented to the Emergency Department with abdominal pain. Chief Complaint: Worsening, diffuse abdominal
8/29/2016 DIVERTICULAR DISEASE: WHAT EVERY NURSE PRACTITIONER SHOULD KNOW. LENORE LAMANNA Ed.D, ANP-C LEARNING OBJECTIVES
DIVERTICULAR DISEASE: WHAT EVERY NURSE PRACTITIONER SHOULD KNOW LENORE LAMANNA Ed.D, ANP-C LEARNING OBJECTIVES Define Diverticular Disease Discuss Epidemiology and Pathophysiology of Diverticular disease
GENI Program: GI and Abdominal Chief Complaints. Kim Macfarlane Clinical Nurse Specialist, Critical Care February 2008
GENI Program: GI and Abdominal Chief Complaints Kim Macfarlane Clinical Nurse Specialist, Critical Care February 2008 Dehydration Common acute and chronic problem Recognition is critically important to
LOKUN! I got stomach ache!
LOKUN! I got stomach ache! Mr L is a 67year old Chinese gentleman who is a non smoker, social drinker. He has a medical history significant for Hypertension, Hyperlipidemia, Type 2 Diabetes Mellitus, Chronic
The Acute Abdomen New Mexico Nurse Practitioner Council Annual Conference, 2012
The Acute Abdomen New Mexico Nurse Practitioner Council Annual Conference, 2012 Darra D. Kingsley, MD Associate Professor, Surgery, University of New Mexico School of Medicine Associate Chief of Staff,
Patient Information. Age: 8 y/o Sex: Female. Date of Admission: Date of Discharge:
Patient Information Age: 8 y/o Sex: Female Date of Admission: 92-10-08 Date of Discharge: 92-10-18 Chief Complaint Severe admominal pain and vomiting with dysuria since last afternoon Present Illness Lower
The EM Educator Series
The EM Educator Series The EM Educator Series: Why is my patient with gallbladder pathology so sick? Author: Alex Koyfman, MD (@EMHighAK) // Edited by: Brit Long, MD (@long_brit) and Manpreet Singh, MD
Non Operative Management of Perforated Duodenal Ulcers. Rabih Nemr M.D. Kings County Hospital Sept 2006
Non Operative Management of Perforated Duodenal Ulcers Rabih Nemr M.D. Kings County Hospital Sept 2006 Case presentation 40 year old male presenting with abdominal pain: Epigastric Worsening over the last
Patient: Becky Smith DOB: 01/26/XXXX Age: 5 y/o Attending: Dr. D. Miles Allergies: NKA MR#: 203. Patient Chart #203 Becky Smith
Patient Chart #203 Becky Smith 1 Property of CSCLV CSCLV Rev: 06/04/2018 Chief Complaint: Abdominal pain. Informant: Parents. HISTORY & PHYSICAL HPI: Ill looking patient, healthy until 2 days ago when
ABDOMINAL TRAUMA. Aurora Health Care EMS Continuing Education 2 nd Quarter 2011 Packet
Aurora Health Care EMS Continuing Education 2 nd Quarter 2011 Packet ABDOMINAL TRAUMA Blunt and penetrating abdominal trauma are major causes of morbidity and mortality in the United States, particularly
Chapter 14: Training in Radiology. DDSEP Chapter 1: Question 12
DDSEP Chapter 1: Question 12 A 52-year-old white male presents for evaluation of sudden onset of abdominal pain and shoulder pain. His past medical history is notable for a history of coronary artery disease,
Genitourinary. Abdomen JENNIFER NOCE CCEMTP/FP-C/CCP-C
Genitourinary Abdomen JENNIFER NOCE CCEMTP/FP-C/CCP-C Objectives To student will be able to identify solid and hollow organs of the abdominal cavity The student will be able to identify the importance
HCPCS Codes (Alphanumeric, CPT AMA) ICD-9-CM Codes Covered by Medicare Program
HCPCS s (Alphanumeric, CPT AMA) 82272 Blood, occult, by peroxidase activity (e.g., guaiac), qualitative, feces, 1-3 simultaneous determinations, performed for other than colorectal neoplasm screening ICD-9-CM
Pediatric Abdomen Trauma
Pediatric Abdomen Trauma Susan D. John, MD, FACR Pediatric Trauma Trauma is leading cause of death and disability in children and adolescents Causes and effects vary between age groups Blunt trauma predominates
LAPAROSCOPIC APPENDICECTOMY
LAPAROSCOPIC APPENDICECTOMY WHAT IS THE APPENDIX? The appendix is a small, fingerlike pouch of the intestinal tract located where the small and large join. It has no known use. It is postulated that the
Abdomen and Pelvis CT (1) By the end of the lecture students should be able to:
RAD 451 Abdomen and Pelvis CT (1) By the end of the lecture students should be able to: State the common indications for Abdomen and pelvis CT exams Identify possible contra indications for Abdomen and
Plain abdomen The standard films are supine & erect AP views (alternative to erect, lateral decubitus film is used in ill patients).
Plain abdomen The standard films are supine & erect AP views (alternative to erect, lateral decubitus film is used in ill patients). The stomach can be readily identified by its location, gastric rugae
McHenry Western Lake County EMS System Paramedic, EMT-B and PHRN Optional Continuing Education 2018 #10 Acute GI Bleeds
McHenry Western Lake County EMS System Paramedic, EMT-B and PHRN Optional Continuing Education 2018 #10 Acute GI Bleeds Gastrointestinal bleeding is a very common problem in emergency medicine. Between
Abdo Pain rules & regulations. Mark Hartnell 2010
Abdo Pain rules & regulations Mark Hartnell 2010 Aims Simple rules which might help in patients with abdominal pain Talk about some myths and realities Discuss some practical how to s in day to day treatment
Appendix 5. EFSUMB Newsletter. Gastroenterological Ultrasound
EFSUMB Newsletter 87 Examinations should encompass the full range of pathological conditions listed below A log book listing the types of examinations undertaken should be kept Training should usually
The appendix is a small, tube-like structure attached to the first part of the large intestine, also called the colon. The appendix.
The appendix is a small, tube-like structure attached to the first part of the large intestine, also called the colon. The appendix is located in the lower right portion of the abdomen. It has no known
Request Card Task ANSWERS
Request Card Task ANSWERS Medical Student Workbook Author: Dr Sam Leach, SpR Case 1 What differential diagnoses are most likely? Which investigation is most appropriate? Case 1 The most likely diagnosis
SMALL GROUP DISCUSSION
MHD II, Session 1 Student Copy Page 1 SMALL GROUP DISCUSSION MHD II Session 1 Gastroinestinal Monday, January 9, 2017 STUDENT COPY MHD II, Session 1 Student Copy Page 2 CASE 1 CHIEF CONCERN: "I'm passing
Evidence Process for Abdominal Pain Guideline Research 11/16/2017. Guideline Review using ADAPTE method and AGREE II instrument 11/16/2017
Evidence Process for Abdominal Pain Guideline Research Guideline Review using ADAPTE method and AGREE II instrument Approximately 139 Potentially relevant guidelines identified in various resources* 59
Right Iliac Fossa Pain
Princess Margaret Hospital for Children PAEDIATRIC ACUTE CARE GUIDELINE Right Iliac Fossa Pain Scope (Staff): Scope (Area): All Emergency Department Clinicians Emergency Department This document should
Cecal Volvulus: Case Presentation and Review of CT Findings
August 2011 Cecal Volvulus: Case Presentation and Review of CT Findings Omar Pardesi, Harvard Medical School Year III Our Patient LD: History & Physical HPI: 28 y.o. female presents with diffuse abdominal
9/10/2012. Chapter 44. Learning Objectives. Learning Objectives (Cont d) Bleeding
Chapter 44 Bleeding 1 Learning Objectives Describe the etiology, history, and physical findings of external bleeding Predict hemorrhage on the basis of the patient s mechanism of injury Distinguish between
Abdominal pain with back pain
Abdominal pain with back pain The Borg System is 100 % Abdominal pain with back pain Abdominal pain, also known as a stomach ache, is a symptom associated with both non-serious and serious medical issues.
Common Problems in Urology
Common Problems in Urology 1. Renal Colic Outline 2. Urinary Retention 3. Acute Scrotum Supanut Lumbiganon, MD. Renal colic The most common urologic emergency O Sudden increase of pressure in the urinary
BIOE221. Session 6. Abdominal Examination. Bioscience Department. Endeavour College of Natural Health endeavour.edu.au
BIOE221 Session 6 Abdominal Examination Bioscience Department Examination of the Abdomen Session objectives Understand the organs / structures that are present in the abdominal cavity Understand the importance
Objectives. Pediatric Mortality. Another belly pain. Gastroenteritis. Spewing & Pooing Child 4/18/16
Gastro-tastrophies A Review of Pediatric GI Emergencies Objectives Discuss common presentations of Pediatric Abdominal Pain complaints Discuss work up and physical exam findings Discuss care, management
A Perf-ect Differential
A Perf-ect Differential Carolyn Marcus, MD Disclosure of Financial Relationships Husband works as in-house legal counsel at Sanofi Case Presentation 6 year old boy with a history of constipation presents
Sick or not sick? Objectives. Bilious vomiting. Deadly Misdiagnoses: Kids with GI Complaints. Ronald Dieckmann, MD. Problems in assessment
Deadly Misdiagnoses: Kids with GI Complaints Objectives Understand key assessment techniques for recognition of serious illness in children. Ronald Dieckmann, MD Professor of Clinical Pediatrics and Emergency
To appreciate the unique problems of older surgical patients. To describe the differential and management
To appreciate the unique problems of older surgical patients. t To describe the differential and management of acute abdomen in the older. To recognize and tend to hospital complications in olderpatients.
Appendicitis. Diagnosis and Surgery
Appendicitis Diagnosis and Surgery What Is Appendicitis? Your side may hurt so much that you called your doctor. Or maybe you went straight to the hospital emergency room. If the symptoms came on quickly,
CLINICAL PRESENTATION AND RADIOLOGY QUIZ QUESTION
Donald L. Renfrew, MD Radiology Associates of the Fox Valley, 333 N. Commercial Street, Suite 100, Neenah, WI 54956 6/23/2012 Radiology Quiz of the Week # 78 Page 1 CLINICAL PRESENTATION AND RADIOLOGY
Discussion of Complex Clinical Scenarios and Variable Review ACS NSQIP Clinical Support Team
Discussion of Complex Clinical Scenarios and Variable Review CS NSQIP Clinical Support Team SCR Open Q& Calls The CS NSQIP Clinical Team is trialing Open format Q& calls for NSQIP SCRs Participation in
CASE-BASED SMALL GROUP DISCUSSION
MHD I, Session 11, Student Copy Page 1 CASE-BASED SMALL GROUP DISCUSSION MHD I SESSION 11 Renal Block Acid- Base Disorders November 7, 2016 MHD I, Session 11, Student Copy Page 2 Case #1 Cc: I have had
CASE-BASED SMALL GROUP DISCUSSION MHD II SESSION 6. Friday, MARCH 18, 2016 STUDENT COPY
MHD II, Session 6, STUDENT Copy Page 1 CASE-BASED SMALL GROUP DISCUSSION MHD II SESSION 6 Friday, MARCH 18, 2016 STUDENT COPY Resource for cases: ACP Medicine (Scientific American Medicine) - Vaginitis
Laparoscopy. What is Laparoscopy? Why is this surgery used? How do I prepare for surgery?
What is? Laparoscopic surgery is where your doctor uses a thin, lighted camera and small surgical tool placed through a small (1/2 inch) incision usually in the belly button. To help with the surgery,
Information for Consent Cholecystectomy (Laparoscopic/Open) 膽囊切除術 ( 腹腔鏡 / 開放性 )
Version 1.0 Page 1 of 3 Information for Consent Cholecystectomy (Laparoscopic/Open) 膽囊切除術 ( 腹腔鏡 / 開放性 ) Introduction Gallbladder is a sac connected to the biliary tree. It serves the function of concentration
Problem. A 34-year. year-old woman admitted for control of diabetes develops acute abdominal pain that increases in severity over several hours.
Immediate Questions Problem. A 34-year year-old woman admitted for control of diabetes develops acute abdominal pain that increases in severity over several hours. A. What are the patient's vital signs?
LOOKING FOR AIR IN ALL THE WRONG PLACES Richard M. Gore, MD North Shore University Health System University of Chicago Evanston, IL
SIGNIFICANCE OF EXTRALUMINAL ABDOMINAL GAS: LOOKING FOR AIR IN ALL THE WRONG PLACES Richard M. Gore, MD North Shore University Health System University of Chicago Evanston, IL SCBT/MR 2012 October 26,
Abdominal Assessment
Abdominal Assessment Mary Marian, MS,RD,CSO University of AZ, Tucson, AZ Neha Parekh, MS,RD,LD,CNSC Cleveland Clinic, Cleveland, OH Objectives: 1. Outline the steps in performing an abdominal examination.
Medical PCCN. AACN Progressive Critical Care Nursing.
Medical PCCN AACN Progressive Critical Care Nursing http://killexams.com/pass4sure/exam-detail/pccn Question: 83 What would be identified on the arterial blood gas results as a reflection of acute respiratory
Visit ER at 10:43. Case conference. Past history. Present illlness. Physical examination. Impression
Visit ER at 10:43 Case conference Supervisor: VS 吳柏衡 Presentor: R1 劉邦民 102.12.16 60 y/o male Chief complaint: syncope Triage: I T/P/R:33.2/81/18, BP=78/41mmHg, SpO2=92% Conscious: E4V5M6 Present illlness
INTRA-THORACIC AND INTRA-ABDO-MINAL PERFORATION OF THE COLON IN TRAUMATIC DIAPHRAGMATIC
INTRA-THORACIC AND INTRA-ABDO-MINAL PERFORATION OF THE COLON IN TRAUMATIC DIAPHRAGMATIC Pages with reference to book, From 14 To 16 S. Amjad Hussain, Chinda Suriyapa, Karl Grubaugh ( Depts. of Surger and
Chapter 30 - Abdominal & Genitourinary Injuries
1 2 3 4 5 6 7 8 9 National EMS Education Standard Competencies (1 of 3) Trauma Applies fundamental knowledge to provide basic emergency care and transportation based on assessment findings for an acutely
Evaluation of the adult with abdominal pain in the emergency department
Official reprint from UpToDate www.uptodate.com 2017 UpToDate Evaluation of the adult with abdominal pain in the emergency department Authors: John L Kendall, MD, FACEP, Maria E Moreira, MD Section Editor:
From Inflammation to Ischemia May apply to all luminal structures Obstruction Small or large bowel Appendix Gall bladder Ureter Hydrostatic Pressure:
The Acute Abdomen Surgical Issues for the Family Practitioner Rochelle A. Dicker, MD Assistant Professor of Surgery and Anesthesia UC San Francisco Visceral Pain Vague Deep Associated with nausea/vomiting
Student Notes Chapter 16: Gastrointestinal and Urologic Emergencies 1. Chapter 16. Gastrointestinal and Urologic Emergencies
Student Notes Chapter 16: Gastrointestinal and Urologic Emergencies 1 Chapter 16 Gastrointestinal and Urologic Emergencies Unit Summary Students who complete this chapter presentation and the related course
Emergency Surgery Board Department of General Surgery Rambam Health Care Campus
Emergency Surgery Board Department of General Surgery Rambam Health Care Campus Surgical Complications of Peptic Ulcer Disease Case Presentation and Review of the Literature Case Presentation 40y male
Appropriate Imaging Tests Lead to Meaningful Results. Dr. Richard Wasley May 2011
Appropriate Imaging Tests Lead to Meaningful Results Dr. Richard Wasley May 2011 Summarize the advantages and limitations of specific imaging tests and why clinical information is so important to radiologists
9/21/15. Joshua Pruitt, MD, FAAEM Medical Director, LifeGuard Air Ambulance Iowa PA Society Fall CME Conference September 29, 2015
Unless they prove otherwise. ~Every ED attending ever Joshua Pruitt, MD, FAAEM Medical Director, LifeGuard Air Ambulance Iowa PA Society Fall CME Conference September 29, 2015 AAA with rupture Mesenteric
Measuring What Students Know: Writing Effective MCQ Questions
Measuring What Students Know: Writing Effective MCQ Questions 1 What Can Student Assessments Do? Communicate important content and skills Provide basis for grading, passing, graduation Identify students
Rad Lab 4 Unknowns: Genitourinary!
Rad Lab 4 Unknowns: Genitourinary! Peter Clarke MD! Don Di Salvo, MD! Clerkship Directors for Radiology! Harvard Medical School! Brigham and Women s Hospital! Dana Farber Cancer Institute! Case 1: 69 year
LAPAROSCOPIC GALLBLADDER SURGERY
LAPAROSCOPIC GALLBLADDER SURGERY Treating Gallbladder Problems with Laparoscopy A Common Problem If you ve had an attack of painful gallbladder symptoms, you re not alone. Gallbladder disease is very common.
GASTRO-INTESTINAL TRACT INFECTIONS - ANTIMICROBIAL MANAGEMENT
GASTRO-INTESTINAL TRACT INFECTIONS - ANTIMICROBIAL MANAGEMENT Name & Title Of Author: Dr Linda Jewes, Consultant Microbiologist Date Amended: December 2016 Approved by Committee/Group: Drugs & Therapeutics
Appendicitis. I. Background & Significance: Algorithm Definitions 1. CASE
I. Background & Significance: Appendicitis Appendicitis is one of the most common acquired surgical conditions of childhood. Diagnosis of appendicitis remains difficult. Much work has been done on validation
more intense treatments are needed to get rid of the infection.
What Is Clostridium Difficile (C. Diff)? Clostridium difficile, or C. diff for short, is an infection from a bacterium that can grow in your intestines and cause bad GI symptoms. The main risk of getting
Acute Abdominal Emergencies
CHAPTER 18 Acute Abdominal Emergencies Abdominal Anatomy & Physiology Abdominal A & P Abdominal A & P Most organs contained in the peritoneum Visceral Peritoneum Covers organs Parietal Peritoneum Attached
CEDR 2018 QCDR Measures for CMS 2018 MIPS Performance Year Reporting
ACEP19 Emergency Department Utilization of CT for Minor Blunt Head Trauma for Aged 18 Years and Older Percentage of visits for aged 18 years and older who presented with a minor blunt head trauma who had