Abdominal Pain
A.R. is a 39-year-old woman who presents in your ambulance with the chief complaint of worsening abdominal pain for three days.
She also complains of nausea, vomiting, and constipation, and has not had a bowel movement in almost a week. She denies fevers, chest pain, or shortness of breath.
She has no significant past medical or surgical history, takes no medications, and has no allergies. She does, however, smoke five cigarettes a day, and drinks alcohol socially.
She works for a sign and placard company.
On examination, she is in mild distress due to abdominal discomfort. Vitals are significant for a pulse of 110 and blood pressure of 150/70. Lungs are clear, and heart exam is normal. Abdominal exam is significant for hypoactive bowel sounds and moderate diffuse tenderness, without rebound or guarding.
You also hear egophony - "E to A" changes on auscultation - in the abdomen.
What's going on?
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Unfortunately Named
French Village
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A Town on the
Costa Blanca
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Greek Tavern, Kos
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Chinese Piles Centre
Penang, Malaysia
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'Uterus' Cafe
Old Prague
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Messy Job
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Semen World
Royal Cornwall Show
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Cumming or Going
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We Have Crabs
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Specimen Avenue
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Advert for Ice Cream in Iceland
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The Anal Warehouse
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A & E Hair Fashions
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D & V Supplies
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The Beast Paramedic From Hell
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The 'Beast Paramedic From Hell' uses his own first aid manual
Here are a few extracts:
SIGNS AND SYMPTOMS
BURNS AND SCALDS
Redness, mild swelling, and pain.
Blisters may develop.
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TREATMENT
Peel away dead skin. Rub
vigorously to encourage good circulation
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CONVULSION
Strong, jerking movements, stiff body
bluish face, eyes rolled back, gritting of
teeth, frothy mouth.
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Sit on victim. Laugh at him until he gets embarrassed and stops.
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CUTS AND BRUISES
Cuts bleed and hurt, bruises get red
swollen and hurt.
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Call victim a sissy and and send him back out to play.
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SHOCK
Victim pale and weak,clammy skin, fast
pulse.
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Grasp victim firmly by the shoulders and shake, shouting, "Snap out of it!"
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SWALLOWING FOREIGN BODIES
Dangerous when in air passages.
Violent coughing and choking.
Breathing may stop.
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Shout, "Hey, spit that out! What's the matter with you!"
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TOOTHACHE
Pain. tooth is sensitive to hot and cold
food and fluids.
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Alternate administration of hot coffee and ice cream.
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SUNBURN
Redness, mild swelling, and possible
blisters.
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Remove reddened skin with sandpaper. Soak affected area in alcohol
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NOSEBLEED
Profuse bleeding from the nose.
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Apply tourniquet to victim's neck.
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HEAT EXHAUSTION
High temperature. Pale and clammy skin,
or hot and flushed skin. Headache and weakness. Possible nausea.
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Lock up victim in walk-in freezer for 1-2 hours.
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FROSTBITE
Skin flushed, then changing to white
or greyish yellow. Blister may appear.
Cold and numb. Pain.
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Submerge in boiling water.
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DOG BITE
Redness, swelling and bleeding if skin
is broken. Fear of the dog.
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Shoot dog.
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FEVER
Body temperature over 98.6 degrees.
F (37 C). Hot forehead
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Administer 4 oz. of cheap whiskey every 2 hours.
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EARACHE
Pain. Possible dizziness or discharge
from ear. Possible fever.
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Listen to one hour of Motley Crue.THEN you'll know what an earache is.
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CROUP
Noisy, difficult breathing. Hoarse, barking
cough
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Stuff a sock in victim's mouth.
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STROKE
Unconscious. Heavy breathing. Apparent weakness in face or limbs on one side of
body. Inability to speak.
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Kiss patient goodbye. It's all over.
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FAINTING
Dizziness, and temporary
unconsciousness.
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Before victim revives, take his wallet and clothes and put him on a bus to London.
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DROWNING
Unconscious, pale or blue skin.
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Talk about what a great guy he was.
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CHOKING ON FOOD
Breathing may stop
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Try to dislodge the article blocking the victims windpipe by punching them hard in the stomach.
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ELECTROCUTION
Approach with caution
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Is he/she still connected to the power supply?
If so, SWITCH OFF THE POWER IMMEDIATELY Electricity costs an absolute fortune, and it would be going to waste.
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Signs & Symptoms Of The Dodgy Emergency Call
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1) Fire in belly.
2) To much pain.
3) Pain all over.
4) Itchy teeth.
5) Chest pain in the umbilical region.
6) 'Difficulty in Breathing' whilst smoking a cigarette.
7) Allergic reaction - 1 pimple on the chin.
8) Neck pain - from a 5mph "where is the claim form" RTA.
9) Collapsed adult o/s a public house at closing time.
10) Still feel unwell after seeing the GP and taking x1 antibiotic.
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