EMS103 CHAP 26-31

Your patient is a 40-year-old female who has been experiencing abdominal pain and vomiting for 2 days. She is now responsive to verbal stimulus; has cool, dry skin; a heart rate of 116; respirations of 24; and a blood pressure of 100/70. Which of the following is the best position for transporting this patient?

• Left lateral recumbent with the legs bent

• Sitting up at a 45-degree angle

• Supine with the knees bent

• Sitting up at a 90-degree angle

Answer explanation

The left lateral recumbent position helps maintain airway patency and reduces the risk of aspiration, which is crucial for a patient with vomiting. It also promotes comfort and can aid in circulation.

Which of the following organs is located in the retroperitoneal space?

• Uterus

• Stomach

• Kidneys

• Liver

Answer explanation

The kidneys are located in the retroperitoneal space, which is the area behind the peritoneum. In contrast, the uterus, stomach, and liver are located in the intraperitoneal space.

The detection of a bulging mass through the belly button that is not pulsating should make the EMT suspicious that the patient may be suffering from which of the following?

• Abdominal aortic aneurysm

• Hernia

• Ulcer

• Gastroenteritis

Answer explanation

A bulging mass through the belly button that is not pulsating is indicative of a hernia, where tissue protrudes through an opening in the abdominal muscles. An abdominal aortic aneurysm would typically present with a pulsating mass.

In what position should the patient complaining of severe abdominal pain be placed if there are no signs or symptoms of shock?

• Left lateral recumbent

• One of comfort

• Supine with feet elevated

• Semi-Fowler with knees bent

Answer explanation

The best position for a patient with severe abdominal pain and no signs of shock is 'one of comfort.' This allows the patient to find a position that alleviates discomfort, which is crucial in managing pain effectively.

You respond to an abdominal pain call. Your partner suspects that the patient is having an abdominal aortic aneurysm (AAA). What type of pain is the patient most likely experiencing?

• Visceral

• Tearing

• Referred

• Parietal

Answer explanation

The patient is likely experiencing tearing pain due to the nature of an abdominal aortic aneurysm (AAA), which can cause sudden, severe pain that feels like a tearing sensation in the abdomen or back.

Which of the following is not a cause of parietal pain?

• Bleeding into the abdominal cavity

• Infection

• Muscle spasm

• Inflammation

Answer explanation

Muscle spasm is typically associated with visceral pain rather than parietal pain, which is caused by irritation of the parietal peritoneum due to bleeding, infection, or inflammation.

You are called to a residential neighborhood at 12:30 A.M. Your patient has just finished eating a super-sized meal of deep fried fish. He is now complaining of a "crampy" pain in the right upper quadrant and has had two episodes of nausea and vomiting with green vomit. What condition do you suspect that your patient is experiencing?

• Peptic ulcer

• Appendicitis

• Intestinal obstruction

• Cholecystitis

Answer explanation

The patient's symptoms of right upper quadrant pain, nausea, vomiting with green bile, and recent consumption of a fatty meal suggest cholecystitis, which is inflammation of the gallbladder often triggered by fatty foods.

You respond, along with fire department Emergency Medical Responders, to a 48-year-old female having a syncope episode in the bathroom. You find the patient sitting on the commode vomiting into the trash can. The vomitus appears to look like coffee grounds and has a foul smell. The patient is pale and has been weak for the past few days. She has:

• GI bleeding

• hernia

• peritonitis

• abdominal aortic aneurysm

Answer explanation

The patient's coffee ground vomitus indicates upper GI bleeding, likely from a source such as a peptic ulcer or varices. Her pallor and weakness further support this diagnosis, making GI bleeding the most likely cause.

Which of the following is a concern when caring for the patient with abdominal pain?

• Airway management

• Patient comfort

• Shock

• All of the above

Answer explanation

All of the options are important when caring for a patient with abdominal pain. Airway management ensures breathing, patient comfort is vital for recovery, and shock can be a critical condition that needs immediate attention.

When treating a patient with acute abdominal pain, you should do which of the following?

• Administer sips of water if patient complains of thirst.

• Have the patient lie still and assume a position of comfort.

• Have him drink milk to coat the stomach and reduce the pain.

• Have him take antacids in an attempt to decrease the pain.

Answer explanation

In cases of acute abdominal pain, having the patient lie still and assume a position of comfort helps reduce movement and discomfort, which is crucial for assessment and management.