We start with vital signs to determine your hemodynamic status, then physical exam.

This is a great question. As there are so many possibilities ranging from benign gas, food intolerance to life threatening heart attack, perforated bowel, ruptured aorta this depends upon a careful history and physical examination by an experienced emergency physician. This initial evaluation then guides the need for further testing such as laboratory analysis, imaging, and even admission and specialty consultation. It takes years of testing and experience to learn these nuances, so if such symptoms occur a careful examination by a professional is highly recommended

To ascertain the type and intensity of the stomach discomfort, the triage nurse will promptly take vital signs heart rate, blood pressure, respiration rate, temperature, and oxygen saturation and conduct a fast history. This makes it easier to identify patients who need urgent care. looking for any obvious anomalies, such as scars or distension, on the abdomen. evaluating intestinal activity by using a stethoscope to listen for bowel noises. To find areas of pain, rigidity stiff abdomen, guarding muscle tensing, or lumps, gently feel the abdomen. To check for areas of tympany a hollow sound that frequently indicates gas or dullness which may suggest fluid or a mass, tap the abdomen. Pelvic and rectal examination. A complete urinalysis and blood tests were performed. Imaging tests: ultrasound, CT, MRI, and X-ray

Very common complaint in the ER is abdominal pain and it’s also one of the hardest to figure out. The ER looks for emergencies. It rules out anything that may pose imminent risk or threat to one’s life or safety. It is not the place to get a diagnosis. The longer something has been going on the less likely the ER is going to figure it out. If you have recurrent abdominal pain, that has been going on for quite some time, the er most likely isn’t the place to search for a diagnosis. Labs and imaging are examples of interventions that most likely will be performed to rule out those things that require immediate attention such as diagnosing appendicitis in a pediatric patient. We want to prevent possible rupture by detecting early on ultrasound/possible secondary imaging, prep for surgery and start iv antibiotics. Another example might be ovarian torsion for females experiencing acute pelvic pain/discomfort, and testicular torsion for males as lower quadrant abdominal pain can be a cause of testicular torsion which requires immediate detection and intervention

As with all conditions evaluated by medical caregivers, the first step is to conduct a history to gather details about the chief complaint, which in this case is pain. Then a physical exam is performed. After this, a number of diagnoses may be considered to explain the pain and a decision is made on what diagnostic testing would help confirm a diagnosis.