The woman with a painful tummy (000)

Sally is a 32-year-old accountant who has come in to A&E with extremely sharp and severe epigastric pain, which started last night. She also describes feeling nauseous and has vomited twice in the last 12 hours. When you go to speak to her and introduce yourself as her lovely F1 today, you notice that Sally appears to be in pain and is leaning forward in her bed. She has no allergies or PMH of note.

Her observations are as follows:

Temp 38.5°C

HR 126 bpm

RR 20/min

BP 111/80mmHg

O2: 96% on room air


There are raised WCC and CRP.

What should be your next step in this scenario?


Take a complete history

Administer 75mg pethidine IM

Administer 500mg paracetamol IV