Emergency Department and Inpatient Clinical Pathway for Treatment and Management of Non-Traumatic Pancreatitis
  • Related Orders
  • Behavioral Health Order
  • Integrated Health
  • Clinical Nutrition
Suspected Sepsis
  • Sepsis Pathway ED, PICU, N/IICU or CICU
    • Severe Pancreatitis with Multisystem Organ Failure
    • Admit to PICU as indicated
    • GI Consult
Traumatic Pancreatitis
General Surgery Consult
Known or Strongly Suspected
Metabolic Disorder
Metabolism Consult
  • Diagnostic Criteria for Acute Pancreatitis
  • Requires at least 2 of the following:
    1. Abdominal pain compatible with AP
    2. Serum amylase and/or lipase ≥ 3 times upper limit of normal
    3. Imaging c/w pancreatitis
  • INSPPIRE 2012
Fluid
  • Following NS or LR resuscitation
  • Initiate D5LR or D5NS with electrolytes
  • Rate 1.5 – 2 times maintenance
  • Follow urine output BUN
Nutrition
  • As soon as clinically stable, start oral feeds
  • Consider NG feeds if oral not tolerated
Analgesia
  • Acetaminophen, NSAIDS, nalbuphine
Monitoring
  • Recommendations for lab, Radiology
  • Considerations for additional Evaluation
Assess Treatment Response at 24-48 Hours
Pain controlled
PO hydration, nutrition adequate
Persistent pain
Inadequate PO intake
Pain Controlled.
Adequate hydration, nutrition.
Follow-up GI 24-48 hrs
  • Goals of Treatment
    • Early fluid resuscitation
    • Pain Control
    • Early enteral feeds
Posted: September 2020
Revised: December 2020
Authors: A. Maqbool, MD; N. Tangrea, RN; J. Brownell, MD; S. Irving, PhD, CRNP; A. Grachen, PharmD; W. Kraemer, MD; T. DiMaggio; J. Driggers, RD; M. Mascarenhas, MD; S. Anupindi, MD; S. Mayer-Brown, PhD; M. Kraenbring- Comerford, PsyD; S. Lee, CCLS; J. Allen, CCLS; M. Acord, MD; G. Nace, MD; P. Laje, MD