What to ask
- •SOCRATES
- •Vomiting, bowels, flatus, PR bleeding
- •Past surgery, gallstones, IBD
- •LMP, pregnancy possible?
What to examine
- •Peritonism, guarding, masses, hernial orifices
- •PR if indicated
- •Obs + lactate
Essential investigations
- •Bloods inc amylase/lipase, lactate, group & save, clotting
- •VBG
- •Erect CXR if perforation suspected
- •CT abdomen/pelvis
Immediate management
01 — Resuscitate
IV fluids, analgesia, antiemetic, catheter.
02 — NBM, NG if obstruction / vomiting
Free drainage.
03 — Antibiotics if sepsis / perforation
Per local protocol.
What the registrar will ask
- 01Peritonism?
- 02Lactate?
- 03CT done?
- 04Pregnancy test?
- 05Fit for theatre?
Referral checklist
Ready-to-refer score: 0% — gather the remaining items before calling.