When Stomach Pain is Serious All personal stories are told by Susan, a retired nurse. If you happen to be working triage, or just have a patient that complains of stomach pain, there comes a point that it's an emergency and the physician needs to be called ASAP. Evaluating Stomach Pains If a person comes into the emergency room complaining of pain in their abdomen, there are things you need to consider when evaluating the patient. How intense and severe is the pain? Ask the patient to describe the level of pain on a scale of 1-10. Anything 8 or higher needs to be evaluated further. Does the patient have a temperature? If so, that could mean appendix problems, kidney problems, pancreatitis, and a variety of other conditions. If the fever is less than 100, monitor every few minutes. If it’s more than 100, consult the physician. Has there been vomiting or diarrhea with the stomach pain? Have other family members or friends that have been ill? Have they eaten any meat that was undercooked? Quite often the stomach illness is associated with a virus or food contamination. The main issue in these cases is to get IV fluids starred, as dehydration can be an issue. Where in the stomach is the pain concentrated? This can give some clues as to what may be the problem Also, very important, is the patient male or female? Females can have a wide range of issues associated with the reproductive organs. Related: Healthcare for Uninsured and Underinsured One day working in the emergency room, a 44-year-old female came in with stomach pains that she described as a 9 on the scale. During the administration questions, I questioned when her last menstrual cycle was, a very routine question for female patients. The woman explained that she was going through menopause and it had been a while since her last cycle. That was a red flag, especially considering this patient was overweight, the first thing to do is to check for pregnancy. Sure enough, she was in labor, and she had no idea. This turned out great, she and her husband had tried for 18 years to have a baby unsuccessfully. They had given up 4 years earlier. She described her symptoms to her friends, and they assured her it was menopause, all assuming she could not get pregnant. She was in for the shock of her life that night, when she delivered a 7-pound baby girl.
Both mom and baby were fine, as was dad after his fainting spell. Always verify a female with pain in the abdomen for pregnancy. An unborn baby could be in distress if treatment is delayed. Serious Abdomen Conditions One of the more serious conditions that can occur that would cause severe abdomen pain is a stomach aneurysm. People over the age of 60, especial current or previous smokers are in the higher risk category. This condition is extremely serious, and surgery is required quickly, or it will result in loss of life. The attending physician should be alerted to a high-risk patient with intense pain, tests will be ordered, and if an aneurysm is detected surgery will take place quickly. Unfortunately, even when surgery is performed, many patients do not survive this. Twisted intestines can occur at any age. Because of the massive length of intestines the human body has, on occasion they can get slightly moved and a blockage can occur. This will cause severe pain and should be treated quickly. In some cases, the intestines can be adjusted; however, more often blood supply has been cut off, resulting in the removal of a portion. Related: Interesting Medical Myths Always take severe stomach pain seriously until conditions are ruled out by the physician. Ultrasounds and MRIs can quickly and accurately detect most problems, and should be ordered by the physician upon the initial examination. As for the attending nurse, it is vital that the patient be evaluated and if deemed serious, act quickly. It may just save a life. Related: Registered Nurse Marie Lois Haran, RN, MSN, will be Honorably Mentioned in the Worldwide Leaders in Healthcare Please follow us on Facebook, Linkedin, Pinterest and Twitter