emDocs - April 16, 2018 - Author: Waller A - Edited by: Koyfman A and Long B
"Key Points
- Diagnosis of pancreatitis: 2 out of 3 criteria met => upper abdominal pain (clinical), serum lipase or amylase >3x upper limit of normal (laboratory), or imaging findings of pancreatic inflammation.
- CT is not necessary if diagnosis can be made without it and is better obtained later in the disease course if needed.
- Patients should receive a RUQ US in the ED if it will impact management.
- Be cautious and avoid normal saline for fluid resuscitation (Lactated Ringer’s likely best).
- APACHE II and BISAP score are the most useful predictors of mortality in the ED, but keep the entire clinical picture in mind.
- There is little research to support discharging patients from the ED, but it may be possible in specific circumstances."