OB-GYN-L Messages for July, 2001: Re: Teenager at the ER

Re: Teenager at the ER

From: art fougner, md

evsono@pipeline.com

Thu Jul 12 19:30:25 2001

what has worked for us in the past is to ask the adolescent patient without parent in room "Is there anything you wish to tell me that you feel uncomfortable saying in front of your parent(s)?" in this way you get a history without compromising your patient.

art

At Thu, 12 Jul 2001, Savaris wrote: >
>This is the case.
>
>A 14 yold pat arrives at the ER complaining about vaginal bleeding for 1 wk.
>I ask if her mother or responsable is with her. Her mother comes in the office.
>I take the story where she says that she had no sexual intercourse before.
>Ask her to be examed in the presence of a chaperone and with her mother.
>Explain the mother that everything that I will do I will tell her first and ask
>her permition. The mother agrees.
>Vulvar inspection: minimal bleeding from inside the vagina; himen with signs of
>ruptured.
>I ask the patient if she had sexual intercourse again. She says yes.
>I ask permition to her mother to do a vaginal exam. Mother agrees, but starts to
>cry when she realizes that her daughter is not virgin anymore. She became very
>upset with her daughter.
>I finished the physical exame ask for b-hCG, CBC.
>Mother signs statement that her daughter was examed in her presence with her
>consentiment and has no complains. My collegue signs as a witness.
>
>After that, mycollegue and I started tofind a better way to deal with this
>situation (mother finds out that her daughter is not virgin anymore during the
>physical exame).
>
>Do youhave any suggestion?
>
>Ricardo Savaris, MD
>BraSil

-- art fougner, md

A series of 1000 cases begins with but a single anecdote.

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