Pregnant patients in the ED

Specialties Emergency

Published

Please send me your hospital policy on when an OB patient goes to OB and when they stay in ED. Our policy is 20+ weeks with ANY abdominal complaint that could be labor/complication of preg. goes to OB. (Obviously trauma abdominal complaints get treated in ED first). Now our hospital wants the ED to "screen" all OB's then send to OB if warranted. WE almost had a catastrope last week when a 37 weeker presented with back pain. OB finally accepted and noted late decels and went for STAT c-section. We do not have TOCO in ED, can only monitor fetal heart tones by stethoscope doppler.

Thanks in advance for all who help.

Specializes in ER.

We delivered a 25 weeker in the ER this week...apparantly crack works better than Pitocin...anyway...a few compressions and an intubation later...baby is doing great!!

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We delivered a 25 weeker in the ER this week...apparantly crack works better than Pitocin..QUOTE]

Indeed it does. :o

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Specializes in Trauma, Teaching.

Our ER docs will see a more than 20 weeker if its something simple, like colds etc. We try to screen what the complaint is first. Last month had a girl come in, 24 weeks, c/o rib pain, denied anything abd at all, so we traiged her. Then found out the pain was just like when she had eclampsia LAST time! Had a whomping BP too. Stopped the ED registration, sent her upstairs and they airlifted her out.

20 weeks, go upstairs! If you have a cold, call YOUR doctor! :uhoh3:

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Specializes in ER straight out of nursing school.

This is definitely an ongoing issue in our ED. I had a 36 week 16yo the other day with abd pain. Took her up myself. The OB nurse asked ME "has she been triaged?", asked ME "what is wrong with her", asked ME "has she had any prenatal care?" finally she asked ME "Has she been registered", I looked down at the patient, took her hand in mine, looked at the bracelet on her arm and said quite sternly to the OB nurse "YEP, LOOKS LIKE SHE HAS...., Any more questions?" Made me so mad. It was just a power struggle between OB and ER. Seems to happen quite often.

I had another 28 week preg in a MVA, we cleared her and sent her to OB for 24hr observation, they sent her back down a 2hours later for pain meds because she had a headache (broken nose and 2 black eyes to boot) she had already had a clear CT. The OB staff had not registered her in OB yet, she was still registered as an ER patient. talk about being mad... our charge nurse and the ER doc had a fit! Her OB should have handled it. Come to find out they had not even called him yet. LAZY!

The rule is >20wks for anything OB, goes to OB.

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Specializes in Telemetry, Case Management.

My daughter is 26 weeks pregnant, and fell at work Sunday. Called the OB, she said go to ER.

We walked up to the triage window. The triage nurse said, "Are you pregnant?" She answered yes, and the triage nurse said "DON"T sign in". They sent us over to register, and when we came out of there (five minutes later), an aide was waiting with a wheelchair to take her up to L&D to be checked.

They didn't even ask if she had an earache or a splinter, although they did ask if she was having contractions, bleeding or if her water had broken.

She went up to L&D and was treated great!!!

THAT's how I wish my daughter in law had been treated when she was pregnant.

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