Approach to the Critical Patient

Immediate priorities

Airway breathing circulation threats

Cannot-miss time-critical diagnoses

Early branching on stability

Monitoring and targets

Monitoring bundle

Resuscitation targets

Immediate consults

Consultation triggers

History

Pain characterization

Onset and progression

Location and radiation

Timing relative to triggers

Associated symptoms

Gastrointestinal features

Genitourinary and systemic features

Risk factors and red flags

Disease-specific risk factors

Medication and exposure history

Alarm features

Physical Exam

Vital signs and general appearance

Hemodynamic snapshot

General state

Abdominal examination

Inspection and auscultation

Palpation findings

Special maneuvers and PITFALLS

Provocative maneuvers

Adjacent system exam

PITFALLS

Differential Diagnosis

Cannot-miss diagnoses

Vascular catastrophes

Surgical emergencies

Reproductive emergencies

Common diagnoses by region

Right upper quadrant

Lower abdomen and flank

Diffuse or epigastric

Extra-abdominal mimics

Laboratory Tests

Core diagnostic labs

Hematology and infection markers

Metabolic and organ panels

Perfusion and bedside tests

Lactate

Point-of-care pregnancy test

Urinalysis

Preoperative and adjunct labs

Type and screen

Venous blood gas

Blood cultures

Diagnostic Tests

Scoring Systems

Appendicitis stratification

Severity and bleeding tools

Limitations

MRI

MRI abdomen and pelvis indications

Performance and guidance

CT

CT abdomen and pelvis with contrast

Contrast and risk considerations

Ultrasound

Point-of-care ultrasound

Formal radiology ultrasound

Disposition

Admission and escalation

Admission indications

ICU and operative escalation

Discharge and follow-up

Safe discharge criteria

Follow-up and safety net

Treatment

Resuscitation and supportive care

Initial stabilization

Analgesia

Early analgesia principles

Non-opioid first-line

Opioids

Adjuncts

Antiemetics

First-line antiemetics

Considerations

Definitive and source-directed therapy

Antibiotics for intra-abdominal infection

Source control

Special Populations

Pregnancy

Diagnostic approach

Cannot-miss obstetric causes

Medication safety

Geriatric

Atypical presentation

High-risk etiologies

Management cautions

Pediatrics

Age-specific etiologies

Weight-based analgesia

Evaluation pearls

Background

Epidemiology

Burden of disease

Outcomes

Pathophysiology

Pain mechanisms

Disease mechanisms

Therapeutic Considerations

Diagnostic strategy

Treatment principles

Reassessment discipline

Patient Discharge Instructions

copy discharge instructions

Home care guidance

Warning signs to return to ER

Follow-up plan

Reproductive-age guidance

References

Guidelines and key sources

Primary references

Specialty guidelines

Evidence and coding standards

SymptomDx is an educational tool for medical professionals. It does not replace clinical judgment. Verify all clinical data and drug dosages with authoritative sources.