280 Basic Investigations of Acute Abdominal Pain, Are We Doing the Basics?

Abstract Aim To evaluate compliance with ASGBI, RCS, and NICE guidelines in the initial assessment of patients presenting with acute abdominal pain. Method A retrospective audit was conducted on 1,200 patients presenting with acute abdominal pain between 1st January and 31st February 2025 to the Surgical Emergency Unit or to A & E, Results 200 adult, non-diabetic patients assessed by surgical teams in either ED or SEU were included, Results as below:ParameterED Admissions (n=100)SEU Admissions (n=100)RBS Documented57%4%Indicated for ECG81 patients34 patientsECG Done51/81 (63%)2/34 (5%)Amylase Done88%96%Urinalysis Done36%58%FBC, LFTs, U&E, CRP100%100% Common Diagnoses:DiagnosisED AdmissionsSEU AdmissionsAcute Cholecystitis13%8%Pancreatitis14%3%Small Bowel Obstruction10%3%Non-specific Abdominal Pain8%30%Appendicitis7%9%Required Surgery10%17% Two patients in the ED group presented with hypoglycaemia requiring intervention. Five ECGs in the ED group revealed abnormalities that required either inpatient management or cardiology referral, while that could not be assess in the SEU group due to lack of compliance. In the SEU group, six ASA II–III patients proceeded to emergency surgery without an ECG being performed. Conclusions Despite being guideline-recommended, essential investigations—particularly ECG and RBS—are inconsistently performed, especially in SEU admissions. While urine analysis & amylase compliance was higher in the SEU group. Given the frequency of high-risk conditions such as pancreatitis and small bowel obstruction, RBS and ECG must not be overlooked.