Obstetric Triage and Emergency Care Protocols

by Diane J. Angelini EdD, CNM, FACNM, FAAN (Editor), Donna LaFontaine MD, FACOG (Editor)

Overview

Named a 2013 Doody's Core Title!

2012 Second Place AJN Book of the Year Award Winner in Maternal and Child Health!

This up-to-date handbook of narrative practice guidelines for use in obstetric triage and emergency settings provides speedy access to critical information needed by healthcare providers in obstetrics, midwifery, emergency medicine, and family care medicine. It includes narrative practice protocols that offer point of service management guidelines, diagnostic parameters, ultrasound imaging and other diagnostic modalities, and easy to follow algorithms and tables in each chapter.

This information will enable practitioners to easily recognize and understand symptomatology, lab results, diagnostic imaging and clinical workings. Chapters address over 30 clinical conditions and are consistently organized to include presenting symptomatology, history and data collection, physical exam findings, lab and imaging studies, differential diagnosis and clinical management and follow up. The book disseminates the contributions of expert midwives, nurse practitioners, obstetricians, gynecologists, and radiologists who evaluate more than 30,000 obstetric visits each year.

Key Features:

• Pocket-sized and easy-to-use
• Includes current guidelines for more than 30 clinical situations requiring obstetric triage or emergency care
• Offers plentiful diagnostic and imaging guidelines with accompanying figures and images
• Presents algorithms, diagnostic images, and best evidence for each condition

Product Details

ISBN-13:	9780826108913
Publisher:	Springer Publishing Company
Publication date:	07/27/2012
Sold by:	Barnes & Noble
Format:	eBook
Pages:	360
File size:	3 MB

About the Author

Diane J. Angelini, EdD, CNM, FACNM, FAAN, is Director of Midwifery at Women and Infants’ Hospital and Clinical Professor, Department of Obstetrics-Gynecology at Alpert Medical School of Brown University.

Donna LaFontaine, MD, is the former Director of OB-GYN Triage and Obstetrical Gynecology and Emergency Medicine at Women and Infants’ Hospital and Clinical Associate Professor in the Department of Obstetrics-Gynecology at the Alpert Medical School of Brown University.

Table of Contents

"

Contributors

Preface

Acknowledgments

I. INTRODUCTORY CHAPTERS

1. Overview of Obstetric Triage and Potential Pitfalls

2. Legal Considerations in Obstetric Triage: EMTALA and HIPAA

II. MANAGEMENT OF OBSTETRIC CONDITIONS IN EARLY PREGNANCY

3. Management of Ectopic Pregnancy

4. Vaginal Bleeding in Early Pregnancy

5. Recognition and Treatment of Postabortion Complications

6. Abdominal Pain and Masses in Pregnancy

7. Pregnancy Loss Prior to Viability

8. Early Complications of Multiple Gestations

9. Nausea, Vomiting, and Hyperemesis of Pregnancy

10. Medical Conditions in Early Pregnancy

III.MANAGEMENT OF OBSTETRIC CONDITIONS

11. Fetal Evaluation and Clinical Applications

12. Limited or No Prenatal Care at Term

13. Preterm Labor 119

14. Preterm Premature Rupture of Membranes

15. Trauma in Pregnancy 137

16. Severe Preeclampsia or Eclampsia and Hypertensive Issues

17. Labor Evaluation 159

18. Severe Medical Complications in Pregnancy

19. Vaginal Bleeding in Pregnancy

IV. MANAGEMENT OF COMMON OBSTETRIC CONDITIONS THROUGHOUT PREGNANCY

20. Common General Surgical Emergencies in Pregnancy

21. Management of Biohazardous Exposure in Pregnancy

22. Infections in Pregnant Women

23. Intimate Partner Violence and Sexual Assault In Pregnancy

24. Substance Use and Psychiatric Disorders in Pregnancy

25. Sexually Transmitted Infections

V. MANAGEMENT OF POSTPARTUM COMPLICATIONS COMMONLY SEEN IN OB TRIAGE

26. Postpartum Preeclampsia Complications

27. Postpartum Breast Complications

28. Secondary Postpartum Hemorrhage and Endometritis

29. Psychiatric Complications in the Postpartum Period

30. Critical Postpartum Medical Complications

Index

"

Editorial Reviews

Reviewer: Anthony Shanks, MD (Indiana University School of Medicine)
Description: This is a collection of narrative protocols to assist practitioners in an obstetric triage setting.
Purpose: The intent is to provide guidelines — and the evidence behind them — in order to accurately and efficiently triage pregnant patients. These certainly are worthy objectives and the authors do a sufficient job of meeting them.
Audience: Practitioners working in a triage or emergency setting are the primary audience. Nurse practitioners and physicians who are not obstetricians particularly may appreciate the narrative style. The authors include attending physicians, midwives, and fellows.
Features: The book is divided into common problems encountered in obstetric triage by gestational age of presentation. Early pregnancy issues are addressed first, followed by conditions that occur only after viability. Other sections include obstetric problems that appear throughout pregnancy as well as those in the postpartum setting. In general, the topics and chapters are well organized and well thought out. The idea of a narrative outline is good, though it would be helpful to actually print the algorithm. For practitioners working in triage settings where time is of the essence, a simple flow chart would have added value to these chapters. The ultrasound images are nice, but there could be more figures and illustrations. The nausea and vomiting chapter is well done, making good use of tables and providing a good source of information about alternative treatments. The paragraph on bariatric surgery seems out of place. I particularly liked the chapter on substance abuse — I found myself looking at the table for quick information and appreciating seeing the street names of drugs not commonly listed in textbooks. The use of evidence-based medicine is well integrated into the book. The rationales behind the guidelines are well thought out and backed up. The postpartum sections are standouts and would be especially beneficial for those who do not primarily work with pregnant patients.
Assessment: This is a well done reference, although it could be improved by adding flow diagrams of the guidelines. Nurse practitioners in triage and physicians who are not obstetricians (e.g. emergency medicine physicians) may appreciate it the most.

Doody's Review Service