Abdominal pain is an all-too-common presenting complaint in the emergency department. Which patients are safe to discharge—and which could present medical-legal problems down the line?

That’s just what Diane M. Birnbaumer, MD, FACEP, emeritus professor of medicine at David Geffen School of Medicine at UCLA and senior clinical educator in the department of emergency medicine at Harbor-UCLA Medical Center in Torrance, California, will discuss in her Monday session “The High-Risk Abdomen: Common Complaints and Crashing Patients.”

Dr. Birnbaumer will present specific cases to highlight common errors made when evaluating abdominal pain and how to prevent such problems through the right evaluation and documentation.

One area that Dr. Birnbaumer will focus on is missed diagnoses, especially in higher-risk patients, such as the elderly, children, and pregnant women. Missed diagnoses often include but are not limited to appendicitis, atopic pregnancy, sepsis, stroke, and meningitis. “Always keep [commonly missed diagnoses] in mind when evaluating patients with abdominal pain,” Dr. Birnbaumer advised. A failure to diagnose a problem with abdominal-related symptoms is often associated with malpractice lawsuits, she said.

Dr. Birnbaumer also will address the importance of ordering tests to help make a differential diagnosis, particularly in higher-risk patients. Failure to order certain tests is yet another area cited in lawsuits, she said. “Be judicious, but order the tests necessary to evaluate your patients,” she advised. It’s also important to document your physical examination so there is written evidence that you have been thorough, she said.

Other highlights of Dr. Birnbaumer’s presentation will include:

• A review of testing strategies that can help detect high-risk abdominal complaints.
• A demonstration of documentation strategies to help reduce medical-legal risk and improve patient care.

Vanessa Caceres is a freelance medical writer based in Florida.

Dr. Birnbaumer

The High-Risk Abdomen: Common Complaints and Crashing Patients

Monday, Oct. 26
4–4:25 pm
Room 107 ABC