Provision of airway patency, effective breathing and gas exchange and
circulatory functions producing adequate perfusion (ABC) are vital elements in all
emergent and critical patients. Initial resuscitation should begin with control in a
primary survey both in the field and in the hospital in the management of the patients
with abdominal pain. In a patient whose respiratory patency is under threat, evaluation
and management of the inflammatory process in the abdomen should not be considered
before this is resolved. Differential diagnosis and proper management of abdominal
pain follow the primary survey, resuscitation and resolution of vital threats. IV fluid
therapy and pain management are commenced as prompted by the general condition.
Prehospital providers should operate in communication with the command control
center in this context. “Tubes or fingers for all orifices” can be accepted as a general
approach for the moribund patient to monitor the clinical course. In the hospital, the
emergency physician should relieve the pain expediently after evaluating and recording
the initial vital signs and findings on systemic examination. Antiemetic therapy and
other symptomatic measures should be individualized for the given patient.
Keywords: Abdominal pain, Airway, Breathing, Circulation, Management, Resuscitation
