MANAGEMENT PROTOCOL FOR PROBLE M ON ABDOMINAL PAIN, EPIGASTI C: ADULT PATIENT (Flowchart No. 11) pl. AN A: 1. 2. 3. 4. 5. 6. 7. 8. Detennioe patient's knowledge on the management of problems presented. Based on 1. 0, give the patient sugared water or candy or sweetened juice if the epigastric pain occurred 4-5 hours after a meal or when the patient took medicine for diabetes before onset of the symptoms since the patient is more likely suffering from hypoglycemia or low blood sugar level. Based on 1. 0, do the foll O\";ng if hyperacidity, gastritis or ulcer is suspected: 3. 1 Give/prescribe over-the-counter antacid specifying accurately the dose and frequency of intake. 3. 2 Advise the patient to stop smoldilg, eating spicy or sour food, and drinking coffee, tea, cola drinks and/or alcoholic beverages. 3. 3 Ad,..;se patient to take small frequent meals (like taking small meals every hour). 3-4 Advise patient to avoid taking medicines which are irritating to the stomach like aspirin, erythromycin or medicines for arthritis. Based on 1. 0, do the following in case of gas pain: 4. 1 Advise patient to lie flat on his abdomen. 4. 2 Give/prescribe over-the-counter anti-flatulent preparation specifying accurately the dose and frequency. Based on 1. 0, manage the patient's fever if such sign and symptom is present. Advise patient to have follow-up after five days or earlier if any RED or YELLOW sign and/ or symptoms develop. Do home visit if the patient fails to come back for a follow-up. Do the following during the follow-up 8. 1 Ask the patient if there was some improvement in his condition. 8. 2 If there were some improvement, advise the patient to stop the medication when signs and ·symptoms disappear. 8. 3 If there was no improvement, ask the patientif new symptoms have developed since the last visit. 8. 4 Examine the patient and identify signs which developed since the last v;sit. 8. 5 Proceed with Plan B or C depending on the way new signs and symptoms identified. PLANB: 1. 0 Refer the patient to a doctor within 24 hours. 2. 0 Determine patient's knowledge on the management of problems presented 405 