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Scenario: Abdo Pain


Please note: The users who submit scenarios have declared that all patient details are fiction. We cannot guarentee the accuracy of any suggested treatment or the realism of suggested observations. You should judge these for yourself.



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Scenario Overview:
The first aiders are at an event but are called into a home to see a gentleman in his 30's with abdominal pain. They find the patient lying in their bed with their knees up to reduce the pain, leaning over and in evident pain. In this scenario, the patient has appendicitis and will put the first aiders' history taking skills to the test and give them a practice of dealing with generic abdominal pain.
Difficulty:
First Aider Moderate
How the scenario should progress:
The patient is stable throughout.
Patient 1:
Name: Jermaine Sherman    Age: 33    Sex: Male
Medication: None Known
Allergies: Nuts
Past medical/family/social history: Usually fit and well and hasn't really been into hospital for anything before except for breaking his arm as a teenager.
Findings on examination: Pain started in the night and seemed to be more in the centre of the abdomen but it has now moved down to the lower right hand side of the abdomen. The pain is rated 6/10 although is made worse when moving. On palpation, there is rebound tenderness (increased pain on release of palpation). The patient feels hot to touch and has a raised temperature. Patient feels nauseous but has not actively vomited. Patient has been able to go to toilet since pain began. Pain described as 'bad' but nothing more specific. No injuries can be seen on the patient. The abdomen doesn't appear swollen but there is a small amount of guarding on palpation.
Possible treatment from first aiders: Good history and appropriate referral onto further medical help.
Time after start: 0 mins Will stay fairly similar
Response: Alert
Airway: Yes
Breathing? Yes
Respirations: 18
Pulse: 101
Oxygen Sats: 96
Temperature: 38.2



Tips for the patient actors:
Try to act the pain to help the first aiders in their assessment of you. You can answer the questions although might be a bit breathless from time to time because of the pain (e.g. if you move too much).

Scenario submitted by: Anonymous