63yo M c/o severe abdominal pain that awoke him from sleep at 0600. Presented to ED at 1200 c/o lower abdominal pain. Triage nurse noted patient to be slightly pale so placed the patient into the resuscitation room. +Nausea, no vomiting; no back pain; no chest pain; no SOB; no travel.
O/E: BP: 185/79, HR: 90, RR 16, O2 Saturation: 100% RA, Temperature: 36.5 degrees Celsius
Looks uncomfortable, slightly pale. CVS/Resp – WNL; Abdo: No scars, umbilical hernia present – reducible, but noted to be discoloured – thought to represent Cullen’s sign. Tender to palpation diffusely over abdomen, no guarding no rebound. Peripheral pulses present, extremities warm to touch.
Let’s pull out the POCUS!
