REBEL Core Cast – Basics of EM – Introduction to Abdominal Pain

Take Home Points

• Go in thinking sick vs not sick – this can take time to develop and that’s ok, this skill will come as you see more patients
• If you’re thinking about getting a scan or u/s – just get it! You don’t want to go home thinking you should have gotten a scan and didn’t
• Pain is subjective (what they tell you) and while tenderness is objective (what you see) – scan every patient that has true tenderness
• Perform belly exams with distraction – ask a question while pressing on the belly and look for the involuntary flexing of the abdominal wall which is tenderness, grabbing your wrist which is guarding, or a firm abdominal wall which is rigidity
• Just like real estate – think location location location – this will help guide your differentials and narrow down whats going on
• As a general rule – above the level of the ASIS is abdominal, and below the ASIS is pelvic
• Don’t anchor on a differential – there can more than one thing going on, keep searching if you don’t find an answer in your initial workup

REBEL Core Cast – Basics of EM – Introduction to Abdominal Pain

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Co-Host

James F. Martin, MD
Associate Clinical Professor – Rutgers RWJ
Monmouth Medical Center– RWJBarnabas
Long Branch, NJ

Post Peer Reviewed By: Anand Swaminathan, MD (Twitter: @EMSwami)

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Ellsworth Wright

Emergency Physician at St. Joseph's Regional Medical Center

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