A critical review of Cole, Lynch, and Cugnoni's abdominal pain assessment guidelines

Elaine Cole, Antonia Lynch, and Helen Cugnoni authored a brief article entitled "Assessment of the Patient with Acute Abdominal Pain," which appeared in the May, 2006 issue of Nursing Standard. Both Elaine Cole and Helen Cugnoni currently (as of the time of the article's publication) hold positions in emergency medicine, while the former is also a lecturer in the area. Antonia Lynch is a consultant nurse, and the experience of the writing team is certainly a major asset to its credibility and reliability. This paper will present a brief summary and assessment of this practice guideline, assessing it in terms of its approachability, the clarity of its information, and the ultimate applicability of the information as presented. In order to accomplish this, a summary of the information will be provided.

Summary

The focus of this article, as the title implies, is on the general assessment of patients complaining of abdominal pain. An overview of the subject is given, with notes regarding the commonality of abdominal pain complaints and the many different ways in which this pain can be described. A large portion of the article is devoted to specific diagnoses, with ailments listed as subject headings and descriptions of the pain experienced and other possibly comorbid symptoms as a means of allowing nursing professionals to differentially diagnose from amongst these ailments. In this way the article provides both a general and a specific description of abdominal pain assessment methods for a wide variety of common complaints.

There are several key assessment areas that are identified in the article, beginning with obtaining a detailed history from the patient including specific attention to any previous complaints of abdominal pain. Analysis of the pain itself is also a large part of assessing patients with abdominal pain complains, and a great deal of space is devoted to a description of pain assessment in this article. There are also several other areas of assessment recommended for helping nursing staff achieve accurate and efficient diagnoses of abdominal pain complaints. Analysis of medications, recent and lifetime dietary habits, as well as family medical histories are all used as means of differentiating diagnoses. Rationales for these assessment methods are found almost entirely in the ultimate specific diagnoses of abdominal pain complaints, as the patterns of these illnesses can be discovered through these assessment areas.

When it comes to the specific strategies and tools discussed in the article there is very little given in the way of explicit detail other than that which can be circumstantially inferred from the described assessment methods. Communication is obviously key in achieving an accurate understanding of the pain the patient is experiencing, and calm persistence in this regard is a necessary tool or skill for the assessing nurse. No specialized equipment or tools are generally required for the assessment methods described in this article, though there are times when imaging techniques and other means of assessment are warranted. The article does not focus on any specific population, but rather notes the high degree of frequency with which complaints of abdominal pain are made throughout the human lifespan.

Conclusion

This article is quite clear and concise in its recommendations, making it especially effective for practicing nurses and nursing students alike. By incorporating these methods into nursing practice, nursing staff will save time and energy in assessment and patients will also receive the benefit of receiving quicker assessment and moving onto well place treatments and faster relief of their abdominal pain. This achieves the primary goal in nursing of compassionately addressing patient concerns.