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Perinatal STAR A 30-60 Second Report STAR Report Before Calling The Physician Or CNM 1. 2. 3. Assess the patient. Read most recent notes. Have the chart in-hand. Obstetric Patients Identify yourself
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Discuss the chart with each other. Ask the patient to read the chart after the exam. Make notes of the following: Obstetric Care. Physical Exam: Assessment: Management: 2. A full review of all the above has been completed. You can now inform the patient of all information provided during the pelvic examination. If a referral to an Emergency Department has been made or if the patient needs further evaluation. Continue the examination if a vaginal bleeding is suspected or if bleeding is more severe. The patient will be sent for a blood test to evaluate the level and rhythm of her maternal red blood cells. The baby should be watched if: a. Fever and redness is present. b. Dark-colored vaginal discharge is noted. c. A urine sample is taken. d. All the above symptoms are present for 1. 48 hours. If no response is seen within a few hours, the baby may be transferred to the Neonatal Intensive Care Unit for more thorough examination. NOTE: Do NOT give antibiotics unless the mother complains of severe vaginal bleeding which is not responding to treatment. The baby should have a continuous oxygen tube attached. If uterine perforation is suspected (see Section 4 — Maternal and Fetal Condition and Management) The following procedures are recommended: 1. Do not move the baby. If they are in the mother's lap and have a good pulse, they should be left there until they have enough oxygen. 2. Have a catheter inserted in the uterine artery (it should connect to a vein in the leg). The catheter is the common means of delivery in our practice. 3. If bleeding is ongoing and persistent, then a perineal suture or endometrial clamp is a more desirable approach. 4. If the perineal suture failed the previous day, have the tube in place for 1-2 hours. 5. The placenta is considered non-viable, and it must be removed. If any other condition is present in the family, that will require medical attention. If the mother is experiencing signs or symptoms suggestive of pregnancy, you will need to do an ultrasound examination. If a vaginal discharge and an umbilical cord is palpable. The patient will need to see a medical provider who can give a definitive answer that will allow the mother to begin a treatment plan that can prolong her life. 6. Any other abnormalities that are suspected.
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We're now going to run through a few examples of using s bar in different settings in the emergency department our patient for this will be Edith who is a 72-year-old lady who has had what sounds like a transient ischemic attack which is caused her to fall and fracture the left ankle, and she will be arriving to the emergency department by ambulance the first communication is between the ambulance crew and the emergency department hi this is Roland and my call sign is one I am calling to request a space in your resuscitation room for my patient Edith, and we should be there in about 10 minutes the background is EDA 72 years old lost her balance and fell in her bathroom my assessment is her early warning score is currently one she is fractured her left ankle from clinical assessment but also has a left-sided facial droop and altered speech which a family says is new my recommendation is that a space be made available in the resuscitation room that the stroke team be informed and that orthopedics be on standby in order to manage all of these all the problems this lady has simultaneously done you have any questions