Gynecologic Emergencies

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33
Gynecologic Emergencies
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Pathophysiology

• Pelvic inflammatory disease
• Community-acquired infection
• Affects uterus, fallopian tubes, neighboring
  structures
• Can cause pain, infertility, uterine bleeding,
  discharge, foul smell
• May have fever and chills

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Illustration of the way in which pelvic
inflammatory disease (PID) affects the
reproductive organs.
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Case Study

• You are called for a 22-year-old female patient
  with severe abdominal pain. Upon your arrival,
  the patient is found lying in her bed in a fetal
  position. Her parents say she has felt bad for
  the last 3 days, and now its to a point where
  she can hardly move. The patient greets you when
  you walk in and verbally confirms the story given
  to you by her parents.

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Case Study (contd)

• Scene Size-Up
• Scene is safe.
• Standard precautions taken.
• Patient is 22 years old, female, 120 lbs.
• Entry and egress from site is unobstructed.
• NOI appears to be abdominal pain.
• No additional resources needed.

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Case Study (contd)

• Care provided
• Patient placed on low-flow oxygen.
• Placed in the most comfortable position
  attainable on wheeled cot.
• Transport initiated to ED.
• IV established en route.

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Summary

• Obstetric emergencies should be considered in any
  patient of child-bearing years with abdominal
  pain.
• Pain will not always be related to pregnancy.
  There are also inflammatory and traumatic reasons
  for the pain and discharge.

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Summary (contd)

• History and physical findings will illustrate the
  nature of the emergency.