Gynecological Emergencies

Gynecological Emergencies can include:
Multiple types of chronic or acute infection
Hemorrhage from uterus, fallopian tubes and ovaries
Ectopic pregnancy
Hormones rise and fall stimulating development of eggs in the ovaries. Menses occur approx. every 28 days. First day of menstruation is the first day of the cycle.

Menarche: first cycle age 8-14
Menopause: anywhere from 35-60

Questions need to be broad enough to get information about the whole area:
Is there pain or cramping
Bleeding or discharge
Nausea, vomiting change in appetite
Fever, diaphoresis, sweating
Change in normal bowel habits, constipation/diarrhea Urination, pain with urination, hematuria
Preexisting or chronic medical problems, surgeries
Dysmenorrhea: pain with menses
Dyspareunia: pain with intercourse
Gravida: total number of pregnancies
Para: total number of live births
Example – G5P2 = five pregnancies, 2 live births

Special Concerns:
Professional behavior: establish trust and support Privacy and modesty: limit people on scene
Pain: there could be significant pain and stress

General Examination:
Vital Signs: BP: hypotension could be internal hemorrhage or infection. Pulse: tachycardia due to dehydration, anemia, infection, pain, sepsis. Respiratory rate: could be increased
Skin: cyanosis could indicate anemia or resp. problems
Genitourinary exam: note presence of blood indirectly. No exams
Abdomen = palpate for masses or tenderness. Rebound tenderness is a sign of significant intra abdominal inflammation
Management: O2, tachycardia, hypotension, severe pain i.e. if BP is below 90 start IVs


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