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Re: Evaluation of OB PatientsFrom: Garry E. Siegel, M.D. (garrys@mindspring.com)Wed Nov 21 19:32:30 2007
For lots of reasons, some political, some practical, anyone over 20 weeks (declared or actual) goes to L and D. That said, the ER MDs and triage nurses do have discretion and common sense available to them, so that someone at 22 weeks who needs obvious ER care (extremity care/sprain, laceration) is handled there and THEN sent to L and D for monitoring, etc. The perceived problem is in the law (COBRA, I think) that says in the small print that anyone needs a labor assessment. When I last looked at this as part of the hospital committee, it was not clear at what gestational age. Obviously, someone 8 weeks doesn't need a fetal monitor, and while 24 weeks made obstetric sense, some of the ER docs wanted 16--so we settled on 20! We also ask the ER MD to call the Ob doc, unless they want to hear directly from the L and D nurse who acts on our (or their) behalf. Garry
At Wed, 21 Nov 2007, JSBowpat@aol.com wrote:
>
-- Garry E. Siegel, M.D. Private Practice Roswell, GA
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