Pancreatitis management checklist
Evaluation to guide etiology & management
- RUQ ultrasound
- Calcium level
- Triglyceride level
- Liver function test panel
- Review of medication list for potentially causative drugs
- Use same strategy as for septic shock (e.g. moderate amount fluid, vasopressors if
- Avoid large-volume resuscitation (e.g. fluid balance >3-4 liters positive) as this may
increase the risk of abdominal compartment syndrome.
- Not routinely indicated, but may be considered if evidence of ascending cholangitis or
choledolithiasis (e.g., markedly elevated bilirubin, dilation of the common bile duct).
- Non-intubated: Low-fat diet
- Intubated: Initiate enteral nutrition as soon as hemodynamically stabilized (via either
nasogastric or postpyloric feeding tube).
- Start with scheduled acetaminophen 1 gram Q6hr) and pain-dose ketamine infusion
- Opioids may worsen ileus, limit them as able.
May consider metabolic resuscitation
- Ascorbic acid I .5g IV q6hr, thiamine 200 mg IV ql 2hr, +/- hydrocortisone 50 mg IV q6hr
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