Question

Dropbox Case Scenario: You are the triage nurse in the Emergency Department. Your patient, Mr. Sawyer, is a 50-year-old man who presents with severe abdominal pain, poor appetite, and fatigue. He states the pain awakened him from sleep and he began vomiting. He denies any relief from the pain and he can't get comfortable as the pain radiates to his back and right shoulder. He rates his current pain level as 10/10. He denies any previous medical or surgical history. He denies any tobacco or drug use. States he drinks just a beer or two after work each day" though he reports to "more than usual" alcohol consumption this past weekend after attending a bachelor party. He lives with his wife and 2 children and works fulltime as a construction foreman. Initial vital signs: BP 160/94, resp 24, pulse 100, temp 99.6 orally, pulse ox 99%.

Answer 1

The patient is suffering from acute pancreatitis. The clues in the question are

1. History of chronic alcoholism
2. History of an acute bout of alcohol intake
3. complains of pain in abdomen radiating to the back
4. Complains of pain radiating to the right shoulder ( most likey due to irritation of the diaphragm)
5. The pain is severe

Management of acute pancreatitis is primarily conservative

1. Patient is kept nil by mouth
2. Round the clock i.v. fluids are administered.
3. Pain relief
4. Antibiotic coverage