Assessment Approach
Use OPQRST and ask about nausea, vomiting, diarrhea, bleeding, last meal, and menstrual history. Inspect, auscultate, then palpate gently, saving the most painful area for last. Look for guarding, rigidity, and rebound tenderness.
Location Clues
Right lower quadrant pain suggests appendicitis, and right upper quadrant pain may reflect gallbladder disease. Epigastric pain radiating to the back can indicate pancreatitis or aortic aneurysm. Flank pain radiating to the groin suggests kidney stones.
Red Flags
Sudden severe tearing pain with hypotension raises concern for aortic dissection or rupture. Women of childbearing age with abdominal pain should be considered for ectopic pregnancy. Treat shock, give nothing by mouth, and transport promptly.