FHRs

[Hayduke]

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Do you get fetal heart tones on all pregnant people regardless of c/o?

For example-
17 yo G2P1 in for headache. Now estimated at 28 wks. She's in the ED so pre-natal care is sketchy at best.
Do you doppler or M-mode that belly? I do.
What is the EPs burden in the eval. of these people? My cursory search struck out. Any evidence?

 

[southerndoc]

Yes, almost always.

 

[kungfufishing]

The fetus is more sensitive to hemodynamic changes than mom, which I suppose is at least part of the underlying reasoning behind this habit, although I can't say I really interpret the FHT much. Going at a reasonable rate? Good what's next.

 

[Doctor Bob]

Do you get fetal heart tones on all pregnant people regardless

Yes, within reason.
If mom is here for a laceration, or if she rolled her ankle (and didn't fall), or got something in her eye, etc etc, then no.
But most anything else, yes.

Then again, I like to play with the US machine so I'll look for any excuse to use it.

 

[Jeff698]

Depending on how minor their complaint, I'll either US them myself or have my nurse get FHR with the doppler thingee. Either way, I do one of the two on every pregnant patient, within reason (i.e. I pass on the three weeker with toe pain).

Take care,
Jeff

 

[Seaglass]

Yes, the FHR is a vital sign for the pregnant woman.

 

[DrMom]

I quickly stick the US on every pregnant patient and document FHT. I at least look even on the early pregnancies.

I, too, have been trained to consider it a required vital sign on pregnant patients.

 

[Flopotomist]

we just had a lecture on this suggesting that M mode was more appropriate than doppler as doppler had some theoretical increased risk of fetal harm...

 

[Arcan57]

FHTs on everyone, UA's on everyone that has a complaint not directly referrable to distal extremity trauma.

 

[Seaglass]

There is more acoustic energy assoicated with doppler which in the lab can cause a plate of jello to warm up a bit over the course of 5 minutes, but for our purposes it is no more dangerous than regular b-mode (grayscale) ultrasound.