Acute Abdominal Pain

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.

• If suspected Kidney Stones, refer to SUSPECTED KIDNEY STONE parameter (5.18)
• Refer to ANALGESIA/SEDATION PRACTICE PARAMETERS (2.04)
• Administer nothing by mouth.