Triaging pregnant women in the ED?

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Specializes in OB.

What are your OB unit policies on the triaging of pregnant patients who come to the ED? Do they automatically send every pregnant woman to you, regardless of gestation or complaint? If a 30 week pregnant woman comes in with chest pain, does she come straight to OB or get assessed in the ED first?

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Life threats at my old place (chest pain, etc) ER cleared first.

Posting from my phone, ease forgive my fat thumbs! :)

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Specializes in Pediatric Pulmonology and Allergy.

I presented twice to the ER as a pt while pregnant... once when I spritzed oven cleaner in my eye, and another time when my gallbladder acted up. Both times they wanted to call OB, but I convinced them my problem could be managed in the ER.

I will also say that I was treated much better in the ER while pregnant than when I presented with a similar complaint when not pregnant.

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Specializes in Nurse Leader specializing in Labor & Delivery.

Any woman under 20 weeks stays in ED, regardless of her complaint (sometimes the OB will make special exceptions, though). Women over 20 weeks, if it's an OB-related issue, they get sent to us. If it's something straightforward like a sore throat, they keep them in the ED. If it's something that could be either/or, like back pain or abdominal pain, they send them to us, we triage them, run a strip on the baby, and then if it's determined that it's not OB related, we send them back down to the ED once they've been cleared obstetrically.

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Under 20 weeks ER, over 20 weeks if it is pregnancy related to OBS and over 20 weeks but an MVA or something of that nature mom must first be cleared in the ER then come up to us as happened to me when I was 35 weeks. I was in an MVA and wanted them to do the US or at least a dopplar but nope they said I was the patient and the baby was not yet a concern ( who ended up being perfectly fine). I was so mad since I was A&O X3 and only had muscle sprains/strains. I mean I could see if I was you know unconscious or disoriented but that is how they triage pregnant women here.

Also the Er has no problem calling down a resident for advice though, if they think it is OB related.

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They try to send us everything. I had a 16 weeker with pink eye. And an 8 weeker with a uti. I'm pretty sure we have a policy in place for a certain number of weeks, but it's never followed.

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
What are your OB unit policies on the triaging of pregnant patients who come to the ED? Do they automatically send every pregnant woman to you, regardless of gestation or complaint? If a 30 week pregnant woman comes in with chest pain, does she come straight to OB or get assessed in the ED first?
I agree with Klone....
klone Any woman under 20 weeks stays in ED, regardless of her complaint (sometimes the OB will make special exceptions, though). Women over 20 weeks, if it's an OB-related issue, they get sent to us. If it's something straightforward like a sore throat, they keep them in the ED. If it's something that could be either/or, like back pain or abdominal pain, they send them to us, we triage them, run a strip on the baby, and then if it's determined that it's not OB related, we send them back down to the ED once they've been cleared obstetrically.

Any thing under 20weeks stay in the ED. Greater then 20 weeks will get medical screening/triage and if anything OB related sent to L/D we will treat sore throats/ear aches. All patients have fetal heart tones assessed...and OB/GYN notified.....at 30 weeks chest pain will get a brief medical screen to be sure that hypoxia is not present and needs emergent care......and sent to L/D. All trauma stay in the ED with L/D nurse to come and run a strip on the fetus till cleared by trauma team.
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Specializes in NICU, PICU, PACU.

Once cleared by ER triage they go to OB at any gestation.

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Specializes in Public Health, L&D, NICU.

At my last hospital, we were supposed to get OB patients after 20 weeks unless it was something inherently medical or surgical. In theory. In practice, they tried to send any pregnant woman to us, regardless of gestational age or complaint. Like the 20-something weeker with a hemothorax they brought up in a wheelchair, barely conscious. Our OBs (and all of us) freaked out over that one. As charge, I got in several yelling matches over the phone over issues like whether or not they should check for spinal injuries on an MVA before they sent someone to us, and whether they should deal with a compound fracture before they came to us. I get that the baby is important (probably better than they did) but if mom dies, it doesn't matter that she was pregnant.

And don't even get me started on the ones that got sent to us who weren't even pregnant to begin with.

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