Is this an appropriate consult from me, an EM doc

[unchartedem]

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Hi,

I was wondering if I had an inevitable abortion or incomplete abortion if it's reasonable to give you guys a call. Or should I just go in myself and try to evacuate everything? I'm just starting out as an attending in a community ED so Im asking questions to basically everyone now. I've never managed this alone in residency, but wonder if this changes in practice.

 

[Global Disrobal]

It is absolutely appropriate!

I moonlighted at a small community hospital during my fellowship. The ED docs handled a myriad of GYN issues, arranged follow up with the local practice, and called me just as an FYI and/or curbside. However, with incomplete and inevitable abortions they rightfully consulted. It allowed them to keep on rolling with their patients, while I came in and did what was relatively straightforward.

Good luck with the new job!

 

[THP]

Hi,

I was wondering if I had an inevitable abortion or incomplete abortion if it's reasonable to give you guys a call. Or should I just go in myself and try to evacuate everything? I'm just starting out as an attending in a community ED so Im asking questions to basically everyone now. I've never managed this alone in residency, but wonder if this changes in practice.

I never mind seeing those consults. We often manage them medically and can see them in the office for follow-up in a few days. Obviously, if they are hemorrhaging and need a D&C, definitely call. And if its a second trimester pregnancy, don't forget about cervical insufficiency. Just because they are dilated doesn't mean that its an inevitable Ab. The patient may be a candidate for an "exam indicated" cerclage.

We don't need to be consulted on a threatened Ab.