Acute Abdominal Pain: Difference between revisions

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* If hypotension / shock is present, refer to [[Shock|SHOCK PRACTICE PARAMETER]] (5.13).
* If hypotension / shock is present, refer to [[Shock|SHOCK PRACTICE PARAMETER]] (5.13).
* For patients with severe vomiting, obtain detailed history, and then administer an appropriate antiemetic.
* For patients with severe vomiting, obtain detailed history, and then administer an appropriate antiemetic.
** [[Antiemetics|ZOFRAN (ONDANSETRON HYDROCHLORIDE)]]:
** [[Zofran|ZOFRAN (ONDANSETRON HYDROCHLORIDE)]]:
*** Adult (>12 y/o or 40 kg): 4mg slow IVP. (Consider diluting in 10-20cc to aid in administering slowly) or 4mg/2ml deep IM in a large muscle.
*** Adult: 4mg slow IVP or 1 ODT tab.  
*** Pediatric (<40 kg): 0.1mg/kg slow IVP (max of 4mg)
****When administering IV, consider diluting in 10-20cc to aid in administering slowly or 4mg/2ml deep IM in a large muscle.
** [[Antiemetics|PHENERGAN (PROMETHAZINE)]]:
*** Pediatric: Refer to Handtevy System
*** Adult (>12 y/o or 40 kg): 12.5 MG DILUTED and slow IVP or IM.
***'''NOTE''': Use PO administration route for conscious patients '''ONLY'''.
*** Pediatric (<40 Kg): 0.25 1 mg/Kg DILUTED and slow IVP or IM.
** [[Promethazine|PHENERGAN (PROMETHAZINE)]]:
*** Adult (>13 y/o): 12.5 MG DILUTED and slow IVP or IM.
*** Pediatric: 0.25 - 1 mg/kg DILUTED and slow IVP or IM.
{| class="wikitable"
|-
! The administration of [[Promethazine|PHENERGAN (PROMETHAZINE)]] in pediatric patients should only be considered if there is persistant vomiting and [[Zofran|ZOFRAN (ONDANSETRON HYDROCHLORIDE)]] is not effective.
|}
{| class="wikitable"
|-
! '''BLACK BOX WARNING'''
The IV (perenteral) administration of [[Promethazine|PHENERGAN (PROMETHAZINE)]] has a '''RELATIVE CONTRAINDICATION''' in children under 2 years of age.  The provider must weigh the risk vs. benefit of [[Promethazine|PHENERGAN (PROMETHAZINE)]] administration based on the patient's condition.
|}
* If suspected Kidney Stones, refer to [[Suspected Kidney Stone|SUSPECTED KIDNEY STONE]] parameter (5.18)
* If suspected Kidney Stones, refer to [[Suspected Kidney Stone|SUSPECTED KIDNEY STONE]] parameter (5.18)
* Refer to [[Analgesia and Sedation|ANALGESIA/SEDATION PRACTICE PARAMETERS]] (2.04)
* Refer to [[Analgesia and Sedation|ANALGESIA/SEDATION PRACTICE PARAMETERS]] (2.04)
* Administer nothing by mouth.
* Administer nothing by mouth.
[[Category:Medical|0501]]

Latest revision as of 00:41, 24 April 2020

Section 5 - MEDICAL

5.01 ACUTE ABDOMINAL PAIN

CONSIDER CARDIAC ETIOLOGY.

INITIAL MEDICAL CARE (2.01) - Provide OXYGEN or assist ventilations as appropriate for patient condition. Use vomiting precautions.

  • If hypotension / shock is present, refer to SHOCK PRACTICE PARAMETER (5.13).
  • For patients with severe vomiting, obtain detailed history, and then administer an appropriate antiemetic.
    • ZOFRAN (ONDANSETRON HYDROCHLORIDE):
      • Adult: 4mg slow IVP or 1 ODT tab.
        • When administering IV, consider diluting in 10-20cc to aid in administering slowly or 4mg/2ml deep IM in a large muscle.
      • Pediatric: Refer to Handtevy System
      • NOTE: Use PO administration route for conscious patients ONLY.
    • PHENERGAN (PROMETHAZINE):
      • Adult (>13 y/o): 12.5 MG DILUTED and slow IVP or IM.
      • Pediatric: 0.25 - 1 mg/kg DILUTED and slow IVP or IM.
The administration of PHENERGAN (PROMETHAZINE) in pediatric patients should only be considered if there is persistant vomiting and ZOFRAN (ONDANSETRON HYDROCHLORIDE) is not effective.
BLACK BOX WARNING

The IV (perenteral) administration of PHENERGAN (PROMETHAZINE) has a RELATIVE CONTRAINDICATION in children under 2 years of age. The provider must weigh the risk vs. benefit of PHENERGAN (PROMETHAZINE) administration based on the patient's condition.