Initial Assessment:
Call Surgery Middle Grade (BLP 903)
Go to Acute Abdominal Pain Pathway - General Surgery
Administer Analgesia - Consider:
Must Do Investigations:
Investigations To Consider:
Ectopic Pregnancy Symptom?:
Yes
HR > 100 Systolic BP < 100? - Gynae Registrar to assess in A&E prior to transfer.
No
Stable Obs:
HR < 100
RR < 20
Systolic BP > 100
Pain Score - 0
Temp <38 >36
Observations stable and pain settled with simple analgesia?
Observations Stable : Yes
9am - 6:30pm M-F?
If Yes
Refer to EPAU on 3731
If No
Contact BLP 706 to arrange scan appt for next EPAU session
Observations Stable : No
Transfer to SAU for urgent US with Gynae 1st on call (BLP 855/706) involvement
OBVIOUS
UNCLEAR
Fast scan U/S Abdomen by A&E staff. Confirm AAA?
CT Aorta
Aneurysm Confirmed?
9am till 5pm Mon - Friday: Contact Vascular Services BTH
Outside core hours: Contact Vascular Services RPH
Refer to Medics if any of the following:
Yes
Refer to General Surgery
Go to Acute Abdominal Pain Pathway
Yes
Patient amylase elevated?
Refer to General Surgery
Go to Acute Abdominal Pain Pathway - General SurgeryGo to Acute Abdominal Pain Pathway
Yes
Refer to Medics if any of the following:
Bladder Scan
Catheterise
Record residual volume drained (<15 mins)
>1000mls
Refer to General Surgery
Admit to SAU
< 1000mls
Refer to OTP Urology
Consider Dischargeif patient stable, if not admit to SAU.
Is patient >60 yrs?
Yes
Urgent surgical review if no history of renal stones
U/S Aorta
No - Refer to Urology and go to Renal Colic/Loin Pain Pathway
AAA identified?
Yes - Refer to Vascular Services
No - Refer to Urology and go to Renal Colic/Loin Pain Pathway
If female patient consider referral to Gynae 1st on call (BLP 855/706)
Refer to General Surgery
Go to Acute Abdominal Pain Pathway - General Surgery
Until Patient is diagnosed