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St Michael s & South mead Hospitals Emergency Early Pregnancy Assessment clinic referral form and guidelines January 2012 We are sorry that we cannot accept patients without a referral form or letter.

How to fill out emergency early pregnancy assessment

How to Fill Out Emergency Early Pregnancy Assessment:

1. Gather the necessary information: Begin by collecting the essential details required for the assessment, such as the woman's personal information (name, age, contact details), medical history (any pre-existing conditions, previous pregnancies), and details of the current pregnancy (estimated gestational age, any complications or concerns).
2. Review the assessment form: Familiarize yourself with the emergency early pregnancy assessment form provided. Take note of the sections and questions that need to be completed, such as symptoms experienced by the woman, vital signs (blood pressure, heart rate), and any relevant laboratory tests or imaging results.
3. Document the woman's symptoms: Begin by recording the woman's symptoms in the assessment form. This may include any signs of vaginal bleeding, abdominal pain or cramping, dizziness, or other concerning symptoms that require immediate attention. Ensure accurate and detailed documentation.
4. Assess vital signs: Proceed to measure the woman's vital signs, including her blood pressure, heart rate, and respiratory rate. These values will help determine the severity of the situation and assist in triaging the patient appropriately.
5. Complete the medical history section: Record any pertinent medical history information, including previous pregnancies, complications, or any existing medical conditions. This information will aid in assessing potential risk factors and guiding the appropriate course of action.
6. Include relevant laboratory tests or imaging results: If available, incorporate any relevant laboratory test results or imaging studies into the assessment form. This may include blood work, urine analysis, or ultrasound reports, which can provide valuable insights into the woman's current condition.
7. Provide additional comments or observations: Use the space provided on the assessment form to include any additional comments or observations about the woman's situation. This can be helpful for healthcare providers who will be reviewing the assessment later on.

Who needs emergency early pregnancy assessment?

1. Women experiencing severe abdominal pain or cramping: Those who are encountering intense and persistent abdominal pain or cramping during early pregnancy should undergo an emergency assessment. It is crucial to determine the cause and severity of the pain to ensure the well-being of both the woman and the developing embryo.
2. Individuals with heavy vaginal bleeding: Women who are experiencing substantial vaginal bleeding during early pregnancy require immediate evaluation. This assessment aims to identify the source of the bleeding and provide appropriate care to prevent any potential complications.
3. Pregnant women displaying signs of ectopic pregnancy: Ectopic pregnancy, where the fertilized egg implants outside of the uterus, can be life-threatening if left untreated. Any pregnant woman exhibiting symptoms such as severe abdominal pain, vaginal bleeding, shoulder pain, or dizziness should undergo an emergency early pregnancy assessment.
4. Those with a history of pregnancy complications or high-risk pregnancies: Women with a previous history of complications during pregnancy or high-risk pregnancies should receive an emergency assessment. This ensures that appropriate care and management can be established early on to safeguard both maternal and fetal health.
5. Individuals with concerning vital signs or abnormal laboratory findings: Abnormal vital signs, such as significantly elevated blood pressure or heart rate, along with abnormal laboratory results, such as abnormal liver or kidney function, require immediate evaluation. This assessment helps identify potential underlying issues and guides the appropriate medical intervention.

For pdfFiller’s FAQs

What is emergency early pregnancy assessment?

Emergency early pregnancy assessment is a medical evaluation to determine the health and potential risks associated with a pregnancy in its early stages.

Who is required to file emergency early pregnancy assessment?

Emergency early pregnancy assessment is typically filed by healthcare providers or medical professionals who are assessing the health of a pregnant individual.

How to fill out emergency early pregnancy assessment?

Emergency early pregnancy assessment is filled out by recording medical history, conducting physical exams, and performing necessary tests to evaluate the pregnancy.

What is the purpose of emergency early pregnancy assessment?

The purpose of emergency early pregnancy assessment is to identify any potential risks or complications that may arise during the early stages of pregnancy.

What information must be reported on emergency early pregnancy assessment?

Information such as medical history, current health status, any previous pregnancies, and any existing medical conditions must be reported on emergency early pregnancy assessment.

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