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 Resuscitation - Use same strategy as for septic shock (e.g. moderate amount fluid, vasopressors if needed). - Avoid large-volume resuscitation (e.g. fluid balance >3-4 liters positive) as this may increase the risk of abdominal compartment syndrome. ERCP - 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). Nutrition - Non-intubated: Low-fat diet - Intubated: Initiate enteral nutrition as soon as hemodynamically stabilized (via either nasogastric or postpyloric feeding tube). Pain control - Start with scheduled acetaminophen 1 gram Q6hr) and pain-dose ketamine infusion (0.1-0.3 mg/kg/hr). - 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 #Pancreatitis #Checklist #Diagnosis #Management #CriticalCare
