Emergency Department and Inpatient Clinical Pathway for Evaluation/Treatment of Adolescent with Acute Abnormal Uterine Bleeding
- Additional Considerations
- Social Work Consult
- Peer Educator
Initial MD/CRNP/RN Assessment
Assess | ABC’s, VS Orthostatic BP changes Symptoms of hypovolemia, anemia |
|
---|---|---|
Initial Labs |
|
Stable Hemodynamics
HCG⊕
Immediate transfer to HUP ED
Interfacility Transfer Process
Consider Social Work Consult
Interfacility Transfer Process
Consider Social Work Consult
HCG⊖
Concerning Hemodynamics
- Consider the following based on PE:
- Transfer to HUP if able
- If not stable for transfer
- Consult
- General or Trauma Surgery, and/or SDU
HCG⊖
HCG⊕
- CBC, Type & Screen, PT, PTT
- NS bolus, 2 PIV
- CR monitor, VS q 15 minutes
- Consider need for PRBC's
Mild
- History and physical reassuring
- Hgb > 12 mg/dL, if checked
- Consider Gynecology Consult
Moderate
Hgb 8-12 mg/dL
Severe
Hgb < 8 mg/dL
Indications for Admission
- Significant ongoing blood loss
- Persistent VS abnormality
- Consider for:
- hemoglobin < 9
- psychosocial concerns
Posted: June 2015
Revised: April 2021
Authors: J. Pletcher, MD; C. Jacobstein, MD; J. Posner, MD; J. Lavelle, MD; L. Karel, Pharm D; K. Smith-Whitley, MD; C. Witmer, MD
Revised: April 2021
Authors: J. Pletcher, MD; C. Jacobstein, MD; J. Posner, MD; J. Lavelle, MD; L. Karel, Pharm D; K. Smith-Whitley, MD; C. Witmer, MD