Tummy Ache
EM Clerkship
Zack Olson, MD ; Mike Estephan, MD ; Maddie Watts, MD
4.9 • 816 Ratings
🗓️ 3 May 2016
⏱️ 10 minutes
🧾️ Download transcript
Summary
Don’t forget to do a thorough GU exam!
Step 1: Write Out Your Differential Diagnosis
* Remember 2-4-2-4* (2) In the upper abdomen* Pyloric stenosis* Pneumonia* (4) In the lower abdomen* Hirschsprung’s disease* Intussusception* Appendicitis* Hernia* (2) Genitourinary* UTI* Testicular/Ovarian torsion* (4) Generalized* Volvulus* Necrotizing enterocolitis* Henoch Schonlein Purpura* Diabetic ketoacidosis
Step 2: Do Pediatric History and Exam
* Pediatric assessment triangle* Appearance* Breathing* Color* Birth history* Gestational age* Complications* Eating/drinking/peeing/pooping* Immunizations* Physical exam* Don’t forget GU exam!
Step 3: Five Important Tests
* Finger stick blood glucose* Urinalysis* Chest x-ray* Abdominal x-ray* Abdominal ultrasound
Step 4: Common Treatments
* Fever/Pain* Acetaminophen* Vomiting* Zofran* Diarrhea* NOTHING* Dehydration* Pedialyte
Additional Reading
* Pediatrics History (EM Clerkship)* Pediatrics Exam (EM Clerkship)
Transcript
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| 0:00.0 | Hello, med students. This episode has been sponsored by Freed AI. Do you dread the thought of |
| 0:07.1 | endless charting once you become a doctor? Do you think that doctors should be spending more |
| 0:11.9 | time with our patients and less time mindlessly writing notes? Freed AI is the product for you. It is a |
| 0:20.4 | secure, hippocompliant scribe that anybody can use. |
| 0:24.7 | Focus your energy on what matters, providing good patient care. |
| 0:29.5 | Use coupon code EM50 to save 50% the first month you try it, |
| 0:34.1 | and you can cancel at any time if you decide it's not right for you. You can learn more |
| 0:38.9 | at www.gitfreed.a.i. Hello, med students. My name is Zach Olson, and today I'm going to give |
| 0:50.4 | you the approach to tummyache, the approach to pediatric abdomen, nausea, vomiting, diarrhea, constipation, pain, abdominal |
| 1:01.4 | distension, all of the important GI stuff in kids. |
| 1:06.0 | We're just going to lump all of that together as tummy ache. |
| 1:10.1 | Crying baby with a big distended abdomen? |
| 1:12.5 | Tummy ache. Vomiting? Tummyache. Diarrhea? Tummy ache. It's all the same approach. |
| 1:20.2 | Now, I know that I haven't even done an episode on adult abdominal pain yet, and that core topic |
| 1:26.2 | will come soon, I promise. But I actually think that |
| 1:30.0 | PEDs GI is a better place to start. And here's why. Kids are trickier. They can't articulate |
| 1:36.6 | things well. They're very vulnerable. And for numerous reasons, we have to be very selective |
| 1:42.9 | with our testing. And so you can't just slack off. |
| 1:47.1 | You really have to think through kids. And so if you can master tummy ache, adult abdominal pain |
| 1:53.2 | is going to be super easy. Plus, PEDS GI stuff is all over step two because it covers |
| 1:58.8 | peds and it covers family medicine and it covers surgery. |
| 2:02.5 | And so you really just need to pay attention today, even if you only see adults on your |
... |
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