EMS Gastrointestinal Emergencies - Particular Patient Presentations

In the realm of emergency medical service provision, encountering gastrointestinal emergencies is not uncommon. From gastrointestinal bleeding to acute appendicitis, EMS Providers must be prepared to assess, manage, and provide timely intervention for these critical conditions. Understanding the signs, symptoms, and underlying causes of such emergencies is essential for swift and effective patient care.

Here are some examples of gastrointestinal emergencies an EMT might encounter:

Gastrointestinal Bleeding:

Signs and Symptoms: Hematemesis (vomiting blood), Melena (black, tarry stools), Hematochezia (bright red or maroon-colored stools), weakness, lightheadedness, and abdominal pain.

Examples: Peptic ulcers, Esophageal varices, Gastritis, Diverticulosis, colorectal cancer.

Appendicitis:

Signs and Symptoms: Right lower quadrant abdominal pain, nausea, vomiting, low-grade fever, rebound tenderness.

Example: Inflamed or infected appendix.

Gastroenteritis:

Signs and Symptoms: Diarrhea, vomiting, abdominal cramps, fever, dehydration.

Example: Viral or bacterial infection of the gastrointestinal tract.

Bowel Obstruction:

Signs and Symptoms: Abdominal pain and distension, nausea, vomiting (may be feculent), constipation, inability to pass gas.

Example: Blockage of the intestines, often due to adhesions, hernias, or tumors.

Pancreatitis:

Signs and Symptoms: Severe abdominal pain radiating to the back, nausea, vomiting, abdominal tenderness.

Example: Inflammation, often due to gallstones or excessive alcohol consumption.

Cholecystitis:

Signs and Symptoms: Right upper quadrant pain, nausea, vomiting, fever, tenderness.

Example: Inflammation of the gallbladder, often due to gallstones.

Diverticulitis:

Signs and Symptoms: Left lower quadrant abdominal pain, fever, nausea, change in bowel habits.

Example: Infection or inflammation of small pouches (diverticula) in the colon.

Gastrointestinal Perforation:

Signs and Symptoms: Sudden, severe abdominal pain, rigid abdomen, guarding, rebound tenderness.

Example: A hole or tear in the gastrointestinal tract, often due to trauma or ulceration.

Gastrointestinal (GI) emergencies pose significant challenges for EMS Providers in the field and can vary widely in terms of severity and presentation. Whether managing cases of GI bleeding or identifying and responding to appendicitis, quick and accurate assessment is essential for ensuring positive patient outcomes.

EMS Providers should follow local assessment protocols and communicate effectively with the receiving facility to ensure the best possible care for the patient. Additionally, maintaining good infection control practices and ensuring proper hygiene is essential when dealing with gastrointestinal emergencies, as many are infectious in nature.

By familiarizing themselves with the signs, symptoms, and potential causes of these emergencies, EMS providers can better navigate these critical situations and provide timely and effective care to those in need.