SBO / LBO
[ ] Check for hernias: groin (femoral, inguinal), umbilical, obturator (rectal)
[ ] Check for Howship-Romberg sign, pathognomonic for obturator hernia: medial thigh pain with extension, adduction or medial rotation of that same hip
[ ] Consider sigmoid volvulus (LBO): elderly, esp institutionalized patients; diarrhea and/or constipation; recurring attacks
[ ] KUB only if will expedite care: look for air fluid, pneumobilia, intestinal emphysema
[ ] CT ab/pelvis with IV and PO contrast – but do not delay if vomiting PO, can do with IV
[ ] Morphine 4 mg IV <b>or</b><select><option>Fentanyl 100 mcg IV</option><option>Dilaudid mg IV</option></select>
[ ] Zofran 4 mg IV <b>or</b> <select><option>Compazine 10 mg IV</option></select> PRN nausea
[ ] NS 1L IV bolus
[ ] LR @ 100 cc/hr <b>or</b> <select><option>D5 1/2 NS with 20 mEQ KCl (copious vomiting, nml renal fx)</option></select>
[ ] NGT to low, continuous suction
[ ] post-NGT pCXR
SBO / LBO