What is included in emergency department (ED) care of abdominal pain in elderly persons?

Updated: Jul 17, 2018
  • Author: E David Bryan, MD; Chief Editor: Barry E Brenner, MD, PhD, FACEP  more...
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Answer

Also note the following:

  • Administer IV boluses of normal saline or lactated Ringer solution to patients with suspected volume loss. Carefully hydrate patients with a history of renal disease or congestive heart failure to avoid volume overload.

  • A Foley catheter may be helpful as a guide for volume resuscitation in patients who are sicker. Incontinence is not an indication for a Foley catheter.

  • Keep all patients with abdominal pain as nothing by mouth (NPO) until surgical pathology is excluded.

  • Place a nasogastric tube in patients in whom bowel obstruction, ileus, or upper gastrointestinal (GI) bleeding is suspected.

  • Maintain a low threshold for ordering additional tests such as computed tomography (CT) scanning or ultrasonography.

  • If biliary disease is suggested, dicyclomine (Bentyl) or glycopyrrolate (Robinul) may be administered for pain. Nonsteroidal anti-inflammatory (NSAIDs) agents are very effective for biliary colic but should be administered with caution to elderly patients.


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