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FINAL VERSION For review only. Do not cite, quote, or publish.

Medical: 5 Gastroenterology: 6

  • B.

    Lower gastrointestinal bleeding

    • 1.

      Epidemiology

      • a.

        Incidence

      • b.

        Mortality/ morbidity

      • c.

        Risk factors

      • d.

        Prevention strategies

      • e.

        Pathophysiology

        • (1)

          Lesions

        • (2)

          Anal and rectal lesions

          • (a)

            Hemorrhoids

          • (b)

            Anal fissures

          • (c)

            Fistulas

        • (3)

          Colonic lesions

          • (a)

            Carcinoma

          • (b)

            Polyps

        • (4)

          Diverticula

    • 2.

      Assessment findings

      • a.

        History

        • (1)

          Acute/ chronic

        • (2)

          Vomiting/ hematemesis

        • (3)

          Stool/ melena

        • (4)

          Meal history

        • (5)

          Chest pain/ "gas pain"

      • b.

        Physical

        • (1)

          Altered level of consciousness

        • (2)

          Skin

          • (a)

            Pale

          • (b)

            Cool

          • (c)

            Moist

        • (3)

          Inspect abdomen

          • (a)

            Scars

          • (b)

            Ecchymosis

          • (c)

            Contour

            • i)

              Bulges

            • ii)

              Symmetry

        • (4)

          Auscultate

        • (5)

          Percuss

        • (6)

          Palpate

      • c.

        Assessment tools

        • (1)

          Hematocrit

    • 3.

      Management

      • a.

        Airway and ventilatory support

        • (1)

          High flow oxygen

      • b.

        Circulatory support

        • (1)

          Positioning

        • (2)

          Consider MAST

        • (3)

          Consider fluid bolus or resuscitation

        • (4)

          Consider fluid lavage

      • c.

        Psychological support

      • d.

        Transport consideration

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────────────────────────── United States Department of Transportation National Highway Traffic Safety Administration Paramedic: National Standard Curriculum

7

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