Wednesday, February 21, 2024

EMS Gastrointestinal Emergencies - Patient Assessment

EMS Providers should be prepared to recognize and respond to gastrointestinal (GI) emergencies, as they are relatively common and can range from mild to life-threatening. Here are some key points and examples of gastrointestinal emergencies that EMTs need to be aware of:

1. Signs and Symptoms: Be familiar with the common signs and symptoms of gastrointestinal emergencies, which may include abdominal pain, nausea, vomiting, diarrhea, constipation, blood in vomit or stool, and abdominal distension.

2. Dehydration: Many GI conditions can lead to dehydration due to fluid loss from vomiting or diarrhea. EMTs should be skilled in assessing a patient's hydration status by checking vital signs (e.g., blood pressure, pulse, skin condition) and mucous membrane moisture.

3. Abdominal Pain Assessment: Learn how to perform a thorough abdominal pain assessment, which includes identifying the location, intensity, and radiation of pain, as well as any aggravating or alleviating factors.

    -  Visceral pain originates from internal organs and is often described as a diffuse, deep, and aching sensation.

    -  Parietal pain originates from the parietal peritoneum and is typically sharp, well-localized, and easier to identify.

4. Gastrointestinal Bleeding: Understand the signs of gastrointestinal bleeding, such as hematemesis (vomiting blood), melena (black, tarry stools), and hematochezia (bright red blood in stool). Be prepared to manage bleeding and provide appropriate interventions.

5. Infection Control: Gastrointestinal emergencies can often be related to infectious causes. EMTs should practice strict infection control measures to prevent the spread of infection, including wearing appropriate personal protective equipment (PPE).

6. Medication Allergies: Ask about medication allergies or intolerances, as patients with gastrointestinal conditions may be taking medications or have allergies to specific drugs.

7. Abdominal Trauma: Consider the possibility of trauma, especially in cases of severe abdominal pain. Assess for signs of external trauma and be prepared to manage accordingly.

8. Patient History: Obtain a detailed patient history, including any pre-existing gastrointestinal conditions, previous surgeries, and current medications.

9. Vital Signs: Monitor vital signs regularly, paying close attention to changes in blood pressure, heart rate, and respiratory rate. These can indicate the severity of the condition.

10. Transport and Communication: Determine the need for transport to a medical facility based on the severity of the condition. Communicate effectively with higher-level medical providers to provide a smooth transition of care.

11. Patient Comfort: Help alleviate discomfort and anxiety in patients with gastrointestinal emergencies. Position the patient comfortably and provide reassurance.

12. Documentation: Maintain accurate patient care documentation, including the patient's history, assessment findings, interventions performed, and the patient's response to treatment.

EMS Providers should perform a thorough patient assessment, obtain a medical history, and note any pre-existing gastrointestinal conditions. 

In cases of GI bleeding or severe abdominal pain, initiate prompt transport to a healthcare facility. Monitoring vital signs, assessing for signs of shock, and providing appropriate interventions such as intravenous fluids can be life-saving.

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