Er Vs Ob

  1. Maybe one of you have had the same problem as we are having:
    The ER calls in the middle of the night and says we are sending a mother up who is going to deliver any second, they usually come up with an aid who has no gloves no BOA pack and is running with the PT down the hall as the PT is pushing ...isn't this an EMTALA violation? and any ideas on how to fix this problem ... we have gone to the head of nursing and have received very little support ... we are four floors up and all the way on the other side of a medium sized hospital with elevators that often just stop because they feel like it, we are just biding our time until we have a bad outcome, we have even offered to come to the ER to help if they are going to deliver but they just keep sending them (last night we had a thick mec baby with slight shoulder distocia deliver 3 min after arriving to the floor)... any suggestions would be appreciated
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  2. 6 Comments

  3. by   canoehead
    In our hospital if they were crowning they stayed in the ER, otherwise they got run upstairs, ready or not. I can't imagine EMTALA applying within the institution.
  4. by   HappyNurse2005
    We've had precip deliveries in the ED once or twice. once, they called up saying they had a lady down there screaming, trying to push, could they bring her up? so we quickly get a room ready and get the lady in bed....she's 5cm.

    of course, ob pt's with ob problems aren't examined in the ED (unless less than 20w preg). they are taken to ob triage, info obtained, call us, and bring her up to OB triage. the precip deliveries are usually those taht come in for "abdominal pain" aka contractions, what the heck do you mean i'm pregnant and in labor, i didnt know i was pregnant.
  5. by   DST2RN
    Our maternity center is outside in a total different building say a 1/8 mile away so if they come into our E.R. the triage practioner will take a look if it's close or ready to do a stop and drop as they say she will push a code yellow button and a M.D. R.N. the Np already present and a RRT will respond and take care of business, we have a code yellow cart in triage all set up ready to go with all that OB stuff.
  6. by   magz53
    Our ER brings any OB patient up to us.........no matter WHAT reason they present to the ER..... so fast they get whiplash in the wheelchair. I once had a patient with a broken ankle !!! Oh but she was pregnant !! Not contracting, no OB complaints, but I ( lone L & D nurse, no midlevel, no MD )had to see her first to r/o labor !!!! I agree moms who have been in an MVA should be monitored for potential abruption etc. but could an ER doc evaluate them first for a broken bone ??? Not in our facility, if you are pregnant you go to OB !!!! This has caused so much friction in our facility and ER is constantly writing up our nurses for their "attitude". Nothing concrete that they can quote or report.........just our "attitude". Oh Lord, help me hang on.
  7. by   chip193
    Quote from magz53
    Our ER brings any OB patient up to us.........no matter WHAT reason they present to the ER..... so fast they get whiplash in the wheelchair. I once had a patient with a broken ankle !!! Oh but she was pregnant !! Not contracting, no OB complaints, but I ( lone L & D nurse, no midlevel, no MD )had to see her first to r/o labor !!!! I agree moms who have been in an MVA should be monitored for potential abruption etc. but could an ER doc evaluate them first for a broken bone ??? Not in our facility, if you are pregnant you go to OB !!!! This has caused so much friction in our facility and ER is constantly writing up our nurses for their "attitude". Nothing concrete that they can quote or report.........just our "attitude". Oh Lord, help me hang on.
    We have the opposite problem here. Nothing goes to L&D unless you see a head or can prove it's labor. But don't let them deliver in that dirty ER - take a quick run upstairs with her panting!
  8. by   widi96
    I work in an ER and we are fairly OB phobic. I am a tech and have been sent on numerous trips to take patients to the OB unit. The last time we had a patient that came through the ER that was close - we had two RN's and me go up with her. We did have gloves, but no pack or any supplies. There is one in the ER, but on the other end - by the time we would've gone and gotten it, we would've been half way to the OB unit.
    Our original plan was that the OB nurses would come over and get the OB patients, but they seem to have gotten out of the habit of that.
    We are pretty reasonable with what we send to OB - if they are over 20 weeks and have any problems with abd pain or vag bleeding - they immediately go to OB. If they fell and hurt their ankle - unless they fell onto their belly - they get seen in the ER. We did have a very pregnant woman involved in an MVC that we activated trauma on and our very cooperative OB staff sent a nurse and a monitor down.

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