Emergency Medicine Triage and Abdominal Pain Quiz

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Questions and Answers

What is the primary focus during the triage process after casualties are triaged?

Treating patients with yellow tags first

Conducting psychological assessments of the patients

Establishing command and a medical officer

Focusing on treatment of patients based on their tag color (correct)

Which of the following actions should be performed first for a patient identified with a RED TAG?

Document the patient's injuries before moving on

Provide immediate surgery to stabilize the patient

Control any major hemorrhage (correct)

Administer an antidote and move to the next patient

What does the 'RPM' acronym stand for in assessing patients during triage?

Respiratory, Perfusion, Mental Status (correct)

Resuscitation, Pressure, Mentality

Respiration, Pulse, Motion

Reaction, Pain, Mobility

In triage situations, what color tag indicates a deceased patient?

BLACK TAG Signup and view all the answers

What should be done for those who cannot walk during the global sorting step of triage?

Have them indicate movement to be assessed second Signup and view all the answers

Which protocol addresses the management of altered mental status?

UP-4.Altered Mental Status Signup and view all the answers

What is the focus of the AC-5 protocol?

CHF / Pulmonary Edema Signup and view all the answers

Which section includes protocols related to pediatric airway management?

Airway Respiratory Section Signup and view all the answers

Which protocol is associated with emergencies involving indwelling central lines?

UP-8 Emergencies Involving Indwelling Central Lines Signup and view all the answers

What is the content of the protocol labeled UP-12?

Police Custody Signup and view all the answers

What does the AC-6 protocol address?

Tachycardia Narrow Complex Signup and view all the answers

Which of these protocols focuses on patient care during an emergency situation?

UP-1.Universal Patient Care Signup and view all the answers

Which protocol specifically addresses seizures?

UP-13.Seizure Signup and view all the answers

Which type of precaution requires the use of a standard surgical mask for both healthcare providers and patients?

Droplet precautions Signup and view all the answers

Which condition is specifically contraindicated for the use of Ibuprofen?

Renal disease Signup and view all the answers

What additional protective measures are included in all-hazards precautions compared to droplet precautions?

Airborne precautions and contact precautions Signup and view all the answers

Under which situation should all patients have drug allergies documented?

Prior to administering any medication Signup and view all the answers

Which of the following diseases requires airborne precautions?

Scabies Signup and view all the answers

What should be done if a patient is unable to walk?

Reposition the upper airway Signup and view all the answers

What indicates a patient should receive immediate care during respiratory assessment for adults?

Breathing rate greater than 30 per minute Signup and view all the answers

In pediatric patients, what breathing rate indicates immediate intervention is needed?

Greater than 45 per minute Signup and view all the answers

What is the appropriate response in triage for an adult with no palpable pulse?

Immediately classify as deceased Signup and view all the answers

When is a patient's mental status assessed in the triage process?

After assessing vital signs Signup and view all the answers

Which of the following is considered a sign of poor perfusion in adults?

No palpable pulse Signup and view all the answers

What should be the primary focus in triaging infants?

Performing the repeating triage process Signup and view all the answers

What signifies a pediatric patient in need of immediate treatment based on mental status?

Unresponsive to verbal cues Signup and view all the answers

In respiratory assessment, what breathing rate for adults is deemed normal?

Under 30 breaths per minute Signup and view all the answers

What is the purpose of triage in emergency situations?

Maintain control in overwhelming situations Signup and view all the answers

What percentage of abdominal complaints may have no diagnosis after extensive testing in the emergency department?

40 – 60 % Signup and view all the answers

Which patient population is most likely to present with vascular problems and significant morbidity after age 50?

Elderly patients Signup and view all the answers

What is critical to consider in women of childbearing age presenting with abdominal pain?

Ectopic pregnancy Signup and view all the answers

How should an unstable patient with abdominal pain be treated?

With directed therapy based on presentation Signup and view all the answers

What age-specific blood pressure threshold is critical for newborns aged 0 - 28 days?

<blockquote> 60 mmHg </blockquote> Signup and view all the answers

What should be evaluated for in a patient over 50 years with abdominal pain?

Abdominal aneurysm Signup and view all the answers

What vital sign is often the first indicator of dehydration?

Heart rate Signup and view all the answers

In pediatric patients, abdominal pain and nausea/vomiting can initially indicate what condition?

Diabetes or DKA Signup and view all the answers

Study Notes

Triage

Triage is used to manage a large number of patients, focusing first on those who cannot walk or have obvious life threats.
The RPM system is used to assess patients: Respiratory, Perfusion, Mental Status.
Red tag patients have priority, meaning their treatment is started first followed by yellow and then black.
Deceased patients can be indicated by pulling their shirt over their head.
Capillary refill, a measure of perfusion, might be affected by skin temperature.
Consider age-appropriate heart rate in triage decisions.
The SMART triage tag system is used in NC.

Abdominal Pain

Abdominal pain may arise from many organ systems including; Cardiac, Pulmonary, Endocrine, Genitourinary and Renal systems.
Common causes are difficult to diagnose in the prehospital setting.
Special attention is needed for:
- Elderly: can signal significant morbidity and mortality; Consider cardiac etiology and obtain ECG if warranted.
- Immunocompromised: HIV, Diabetes, Renal Failure, Transplant patients, Patients taking chronic steroids.
- Women of childbearing age: Consider ectopic pregnancy until proven otherwise.
- Pediatric: Blood Glucose Analysis as abdominal pain and N/V can be an initial sign of diabetes or DKA.

Stable vs. Unstable Patients

Stable patients with undifferentiated abdominal pain may require only supportive care, anti-emetics, and pain medications.
Unstable patients need more directed therapy based on their presentation and vital signs.

Recommended Exam for Abdominal Pain

Mental Status, Skin, HEENT, Neck, Heart, Lungs, Abdomen, Back, Extremities, Neuro.
Age specific blood pressure:
- 0 – 28 days > 60 mmHg
- 1 month - 1 year > 70 mmHg
- 1 - 10 years > 70 + (2 x age) mmHg
- 11 years and older > 90 mmHg
Abdominal / back pain in women of childbearing age should be treated as pregnancy related until proven otherwise.
Consider the diagnosis of abdominal aneurysm with abdominal pain, with or without back and/or lower extremity pain or diminished pulses, especially in patients over 50 and/or patients with shock/poor perfusion. Notify receiving facility early with suspected abdominal aneurysm.
Consider cardiac etiology in patients > 50, diabetics and/or women especially with upper abdominal complaints.
Repeat vital signs after each fluid bolus.
Heart Rate:
- One of the first clinical signs of dehydration
- Almost always increased heart rate (tachycardia)
- Increases as dehydration becomes more severe
- Very unlikely to be significantly dehydrated if heart rate is close to normal.

Infection Control

Droplet precautions: include standard PPE plus surgical mask for providers accompanying patients, and a surgical mask or NRB O2 mask for the patient.
- Utilized for: Influenza, Meningitis, Mumps, Streptococcal Pharyngitis, and other illnesses spread via large particle droplets.
- Utilize when a potentially infectious rash is suspected.
Airborne precautions: include standard PPE plus a gown, change of gloves after every patient contact, and strict hand washing precautions.
- Utilized for: Multi-drug resistant organisms (e.g.MRSA), Scabies, Zoster (Shingles), or other illnesses spread by contact.
All-hazards precautions: include standard PPE plus airborne and contact precautions. Utilized during the initial phases of an outbreak when the etiology of the infection is unknown or the causative agent is found to be highly contagious (e.g. SARS).
Document all drug allergies before administering pain medications.
NSAIDs (non-steroidal anti-inflammatory medications) are contraindicated for patients with renal disease or renal transplant.
Do not administer aspirin to children under 15 years old.
Contact medical control before administering any medication, at the Agency Medical Director’s discretion.

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Description

Test your knowledge on triage protocols and the evaluation of abdominal pain in emergency medicine. This quiz covers the RPM system, prioritization of patients, and considerations for various organ systems related to abdominal pain. Enhance your understanding of crucial assessment techniques used in prehospital settings.