Which action is essential at the start of management for acute abdominal pain?

• A. Insert indwelling urinary catheter.
• B. Apply O2 and ensure patent airway.
• C. Immediate surgical intervention without imaging.
• D. Administer IV PPI.

Answer: (B)

Securing the airway and ensuring adequate breathing with supplemental oxygen is the essential first action. In any acute presentation, life support comes before diagnosis or definitive treatment. Providing oxygen helps prevent hypoxemia and supports tissue perfusion as you assess and stabilize the patient, even while abdominal causes are being considered.

After stabilization, you can address imaging and targeted management. Inserting a urinary catheter is not universally required at the outset; it may be used later for urine output monitoring or if indicated by the patient’s condition. Jumping straight to surgery without imaging isn’t appropriate in most cases, since imaging helps distinguish surgical from medical causes and guides the plan. Administering IV proton-pump inhibitor isn’t a universal first step in acute abdominal pain and is reserved for specific indications such as suspected GI bleeding or ulcers.