Predicting ICU interventions in intentional drug overdose

JPN guidelinesfor the management of acute abdomen2015 Toshihiko Mayumi, Masahiro Yoshida, Kouichi Hirata Department of Emergency Medicine, School of Medicine, University of Occupational and Environmental Health, Japan Clinical Research Center Kaken Hospital, International University of Health and Welfare, Japan Department of Surgery, Surgical Oncologyand Science, Sapporo Medical University, Japan Background/Purpose: There have not been the practical guidelinesfor the management of acute abdomenin the world. Therefore, the Japanese Society for Abdominal Emergency Medicineand collaborated 4 other societies began to make the practical guidelinesfor the management of acute abdomen(JPN guidelinesfor acute abdomen) in 2012 and finally published them in 2015. Here, we present brief summary of them. Methods: The working group of JPN guidelinesconsists of 18 specialists, primary care physicians, surgeons, gastroenterologists, radiologists, vascular surgeon, obstetrician and gynecologist, and epidemiologists. The guidelineswere made using EBM methods with level of evidence (body of evidence) and recommendations. Results: JPN guidelinesfor acute abdomen2015 contain 108 clinical questions and major topics as described below: (1) definitions, (2) epidemiology, (3) practical algorithms of acute abdomenand tables of pain location anddisease, (4) history taking, (5) medical examination, (6) laboratory and radiological examination, (7) differential diagnosis, (8) initial treatment, and (9) educational program. For algorithm of initial treatment for acute abdomen, 2 steps method were proposed (Figure). Conclusions: Since these brand-new JPN guidelinesfor acute abdomen2015 are the first guidelines, these need a lot of update to be in line with a clinic in the near future.