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Re: Hospital admissions for obstetric patients From: Joanne Bulley, MD (islesannie@yahoo.com) Sun Oct 29 05:52:25 2006 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Joanne Bulley, MD: "Re: Hospital admissions for obstetric patients" Previous message: R. Daniel Braun: "Re: Patients are using debit and credit cards more than ever" In reply to: Meenan, Anna: "Re: Hospital admissions for obstetric patients" Next in thread: Rita Kucmierz: "Re: Hospital admissions for obstetric patients" As Anna and Joe have observed - and Anna put so succinctly: if it is between the xyphoid and pubis - it "must" be ObGyn and they want us to take care of the patient. I bet we have all had these experiences. When my patients come to me first for things that I don't think are gyn - I tell them it is ok and their primary would have probably told them they had to see me first anyway - so we got it out of the way. I did the culdocentesis on a patient that had a ruptured spleen in a soccer practice (she was the goalie and came to the ER from the field). The ER doc was certain it was a ruptured ectopic when the US showed free fluid in the pelvis. I tried to tell him that we are in modern times and you no longer have ectopics with negative serum HCG's! I was there in the ER - and so did it to show it was blood and told him to get the Surgeon to the ER stat while I was doing the culdo to prove it was blood. Ultimately she did fine, but her dad (from out of town) arrived at the ER as the surgeon walked in and Dad was not happy that he beat the surgeon there. Dad wanted her to be helicoptered to the Boston area for care since we were so slow to assess. The Surgeon did convince him that was not a good idea. At Sat, 28 Oct 2006, Meenan, Anna wrote: > >Reminds me of the perforated peptic ulcer that the OB and i diagnosed >in the ER during my residency. Culdocentesis for probably ruptured >ectopic yielded gastric fluid (no availability of stat U/S back then) >and 3-view abd showed free air. Back then, if anything female with >pain between the zyphoid and the pubis came into the ER, they called >the Ob-gyn resident. > >Anna Meenan, MD > >>When I was a resident (maybe even a student), there was a woman >>bouncing around the ER with abdominal pain and fever, as I recall, >>whom nobody "wanted." Medicine and surgery both declared that "it >>must be PID." Pretty typical. >> >>Well, the chief resident in OB-GYN, being the gentleman and >>physician that he was, admitted the lady under "r/o PID" or some >>such Dx, and she was treated with hydration, antibiotics, etc. >>However, when things started to "go south" that night, they decided >>she at the very least had a ruptured TOA. So we went to the OR with >>this "r/o PID -- poss. rupt. TOA" patient and opened her up. And >>found soap. >> >>We had to call the surgery resident and his staff, who were not in >>the hospital and had to come over from the VA, to handle this woman >>with hemorrhagic pancreatitis whom nobody wanted to admit but us. >> >>Joe P. -- Joanne Bulley, MD Keene, NH, USA Next message: Joanne Bulley, MD: "Re: Hospital admissions for obstetric patients" Previous message: R. Daniel Braun: "Re: Patients are using debit and credit cards more than ever" In reply to: Meenan, Anna: "Re: Hospital admissions for obstetric patients" Next in thread: Rita Kucmierz: "Re: Hospital admissions for obstetric patients"

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