Prehospital Assessment of Non-Traumatic Abdominal Pain

Abstract

Background: Non-traumatic abdominal pain may have several causes and often needs physicians’ consultation. In a pilot study, a template was used to assist ambulance nurses and technicians to assess this medical condition. Objective: This study aimed to evaluate the use of the template and the outcome of the pilot study. Methods: A prehospital template (protocol) consisting of validated physiological and clinical scales, such as “Rapid Emergency Triage and Treatment Scale-Ambulances”, “Patient Behavioral Pain Scale”, and “Visual Analog Scale” were used to assist the ambulance crew in Shiraz, Iran, to assess all cases with non-traumatic abdominal pain. The outcome of the evaluation in this group was compared with a control group using the normal routine of assessment. Results: Of 200 prehospital patients, 170 cases were eligible for evaluation. The majority of the patients in the protocol (n=88) and control groups (n=82) were males (n=46 and n=43, respectively). There was a slight but statistically significant difference between the two groups in favor of the protocol group concerning the need for ambulance transport and direct admission to the hospital (P<0.02). Conclusion: Although prehospital assessment and management of non-traumatic abdominal pain continue to be challenging for emergency medical staff, educational initiatives together with prehospital guidelines may improve the accuracy of prehospital decision-making and open up for new fast-track diagnosis and direct admission to the hospital.