Self-Assessment Questions (SAQs) for Study Session 8

Answer

• a.Gastrointestinal emergencies are more difficult to recognise in very old and very young people.
• b.The signs and symptoms that are common to both appendicitis and intestinal obstruction are abdominal pain, guarding the internal organs with rigid abdominal muscles, nausea and vomiting, and fever.
• c.A person suffering with acute appendicitis is more likely to experience lower abdominal pain, particularly on their right side. An intestinal obstruction usually produces widespread abdominal pain, the abdomen may be swollen and the person may have difficulty in passing faeces or gas.

Answer

Life-supportive care for patients with gastrointestinal emergencies depends on the severity of the symptoms. If the symptoms began very recently, give two paracetamol tablets with a small cup of water to relieve the pain. If the symptoms are advanced and there are signs of shock, begin IV fluid administration. In both cases, refer the patient to the nearest hospital or health centre, instructing them to take nothing by mouth before they have been seen by a doctor, because surgical intervention is likely to be required.

Answer

A is false. Abdominal thrusts are applied to help someone who is choking to cough the obstruction out of their airway. This technique is useless to help someone who has swallowed poison, which will be absorbed into their body through the digestive tract.

B is true. If you suspect that a person has absorbed poison through their skin, remove any contaminated clothing and wash the body with soap and water before referring them.

C is true. Swallowing bleach or kerosene is a common method of trying to commit suicide in rural communities in Ethiopia.

D is false. Tying a cloth over the nose and mouth is not adequate protection for someone who is spraying houses to kill mosquitoes. Insecticide sprayers should wear proper protective clothing, including a special mask.

E is true. Burning charcoal in an enclosed room is dangerous because the fumes are poisonous and inhaling them can cause loss of consciousness.

Answer

• a.You suspect that Mrs Chaltu has tried to kill herself by drinking a poisonous chemical. Look for any empty containers in her surroundings to see if you can identify what she has swallowed. Take the containers with you to show the doctor when you transport Mrs Chaltu to the nearest health facility.
• b.She is unconscious so you should apply the basic life support techniques outlined in the ABCDE-T approach, first making sure that her airway is open by placing her in the recovery position (Figure 8.2), and checking her breathing, pulse and blood pressure. If she is not breathing, begin rescue breathing for her. Once she is breathing, if there are signs of burning on her lips, mouth and throat (e.g. from swallowing bleach or kerosene), give her sips of cold water or milk. Check for any signs of disability and examine her body in case there is anything you have missed. Go with her on the transfer to the health centre or hospital.

Answer

Mr Shewangizaw is choking, probably caused by a blockage of food in his airway. He should be encouraged to cough to remove the obstruction. If this does not work, you should support the effort by slapping his upper back. If the back slapping does not work, use the abdominal thrust technique. If he becomes unconscious, lay him down and see if you can remove the obstruction from his throat with your fingers or forceps. Begin rescue breathing to keep him alive while he is taken to a hospital or health centre.