Male grasping abdomen with both hands

Important Steps for a Triage Nurse Evaluating Male Abdominal Pain

When your male patients call your practice to report abdominal pain, it’s important that the responding nurse considers all possible reasons — and obtains all necessary information — to get a clear picture of the patient’s symptoms. Not only is abdominal pain fairly common, the root causes of it can vary greatly, as can the severity of its discomfort. Each case requires a triage nurse to consider the worst-case scenario based on a full picture of the associated symptoms, and use the most up-to-date triage protocols so that each patient receives the appropriate level of care — at home, from a doctor, or in the ER. This methodology also prevents nurses from engaging in potential negligence.

Click here to watch a video by Dr. Ravi Raheja on how to evaluate 911 calls.

How do you define it?

In a nutshell, male abdominal pain is pain that’s localized anywhere between the bottom of a patient’s ribcage and their groin crease. Pain severity can be defined as mild (the abdomen is soft but not tender to the touch, and the patient can perform normal activities), moderate (the abdomen is tender, interfering with normal activities), or severe (the pain is excruciating, and the patient is either doubled over or unable to do normal activities).

What causes it?

Reasons for abdominal pain can vary widely. It could be the result of a benign gastrointestinal disorder, like gas, overeating, or gastroenteritis. Or, the problem could be moderately serious, like appendicitis or biliary colic (gallstones). There’s also the possibility that the pain could be a warning symptom of a more life-threatening condition, like perforated peptic ulcer disease, mesenteric ischemia, a ruptured abdominal aortic aneurysm, or testicular torsion. Below is a breakdown of the most common reasons based on age group.

Men Younger than 50

  • Appendicitis
  • Testicular torsion
  • Gallbladder disease
  • Irritable Bowel Syndrome
  • Nonspecific abdominal pain
  • Peptic ulcer disease

Men Older than 50

  • Appendicitis
  • Bowel obstruction
  • Diverticulitis
  • Gallbladder disease
  • Pancreatitis
  • Peptic ulcer disease

Location of Pain and Possible Etiologies

  • RUQ: liver and gallbladder
  • Epigastric: heart, stomach, duodenum, esophagus, gallbladder, pancreas
  • LUQ: spleen, stomach
  • Periumbilical: pancreas, early appendicitis, small bowel
  • RLQ: ileum, appendix, kidney, testicular torsion
  • Suprapubic: bladder, rectum, colon
  • LLQ: sigmoid colon, kidney, testicular torsion

Who is more at risk?

Certain groups of people are more likely to have a serious condition when they experience abdominal pain, including:

  • Pregnant women
  • Infants and children below age 5
  • Patients older than 65
  • Patients who have had prior surgeries on their abdomen
  • Patients with numerous other medical problems

Questions to ask younger patients

Adolescent abdominal pain in males can sometimes be difficult to triage because patients aren’t usually the ones speaking to the nurse. Younger patients may also be shy about admitting where they’re feeling pain, such as around their groin. It’s important that nurses ask clearly defined questions to the adults who are speaking on behalf of these patients, and to get permission from them to speak with those patients directly if needed.

Questions should include:

Location. Where does it hurt? If speaking to an adult, have them ask the child or teen to point to the spot that hurts.

Onset. When did the pain start? Be specific in minutes, hours, or days.

Severity. How bad is the pain? A rating scale can be used as needed: Mild (1-3), Moderate (4-7), or Severe (8-10).

Appearance. How sick is your child acting? What are they doing right now? If asleep, how were they acting before they went to sleep?

Recurrence. Has your child ever had this type of abdominal pain before? If yes, when was the last time? What happened that time?

Use Schmitt-Thompson Protocols

All triage nurses will be prepared to offer their patients the best guidance on which medical care to seek if they follow the triage protocols established and updated by Drs. Schmitt and Thompson. These have been demonstrated to cover over 99 percent of all symptom-based calls, and are reviewed by a panel of nurses, consultants, medical directors, primary care providers, specialists, and ER physicians annually. They’re also widely adopted within 90 percent of all nurse triage call centers.

We can help

TriageLogic is ready to help your practice improve its care with all patient callers. We offer free Schmitt-Thompson protocols that your practice can immediately start using, triage software to guide your in-house nursing team and document all patient calls, as well as an outsourced nurse triage call center with specially-trained RNs who can respond to your patients’ needs 24/7. If any of these services would benefit your team, contact us here.

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