Having RAP does not increase the chance that the child will have an ulcer or other intestinal problem as an adult.
There are 4 recommendations for ED patients with low-risk abdominal pain. Photo: Shutterstock.
The Society for Academic Emergency Medicine has published a second version of the “Guidelines for Reasonable and Appropriate Care in emergencies” (GRACE-2, for its acronym in English) in which the treatment of adults with pain lower abdominal riskrecurrent, previously undifferentiated in the ER.
There are 4 recommendations for ED patients with low-risk, recurrent, previously undifferentiated abdominal pain:
If a patient has a TAC negative abdomen and pelvis in the last 12 months, there is not enough evidence to clearly distinguish between patients in whom it is safe to avoid repeating this test and those in whom it is not routinely performed in the ER.
If the patient has a negative CT scan of the abdomen and pelvis with intravenous contrast in the ED, ultrasound is not recommended unless there are concerns or suspicion of pelvic or biliary disease.
The doctor may screen the patient for depression and/or anxiety.
The doctor may use low doses of opioids for pain relief.
This second Guide to Reasonable and Appropriate Care in the Emergency Department (GRACE-2) from the Society for Academic Emergency Medicine deals with the topic “recurring abdominal pain low risk in the emergency department.
The guideline’s multidisciplinary panel applied the approach Grading of Recommendations Assessment, Development and Evaluation (GRADE) to assess the certainty of the evidence and the strength of the recommendations regarding four priority questions for adult patients from the pain emergency department undifferentiated, recurrent, low-risk abdominal pain.
The intended population includes adults with multiple similar presentations of recurrent abdominal signs and symptoms during a period of months or years.
The panel reached the following recommendations:
if a previous negative CT scan of the abdomen and pelvis (CTAP) has been performed within 12 months, there is insufficient evidence to accurately identify populations in which repeat CTAP can be safely avoided or routinely recommended.
if CTAP with intravenous contrast is negative, we suggest once morest ultrasound unless there is concern for pelvic or biliary pathology; we suggest that they be carried out depression screening tests and/or anxiety during evaluation in the emergency department; and we suggest an opioid minimization strategy for pain control.
consulted source here.
