Table 2.

Take-home points for emergency medicine management of AP.

Diagnosis	Symptoms and lipase level elevation define the diagnosis. If there is an unclear diagnosis or severe pancreatitis, imaging is recommended.
Severity	Physiologic derangements and organ injury indicate severity. Consider the use of BISAP or ED-SAS scores in the ED.
Therapy	Pain control	Opiate sparing strategy for mild AP. Judicious opiate as needed for moderate to severe AP.
	Fluid Resuscitation	Moderate (10 mL/kg bolus only in hypovolemic patients, then 1.5 mL/kg/h) was associated with better outcomes than aggressive fluid resuscitation.
	Feeding	Early initiation (even in the ED) as early as tolerated may be associated with better outcomes.
	Investigational therapies	Auxora, infliximab, pirfenidone, and others in development.
Consultation	Driven by etiology and associated complications of AP. Cholecystectomy is indicated during hospitalization for biliary etiology of AP.

AP, acute pancreatitis; BISAP, bedside index of severity in acute pancreatitis; ED, emergency department; ED-SAS, emergency department SPO₂, Age, and systemic inflammatory response syndrome score.