Chapter 24: Gynecologic Emergencies (Block 3)

menarche

what age

onset menstruation

• usually between 11 and 16 years

menopause

what age

end of menstrual activity

• usually around 50 years old

Pelvic inflammatory disease (PID)

s&s

tx

infection of uterus, ovaries, and fallopian tubes

• occurs more in sexually active women

lower abdominal pain (usually starts during or just after menstruation)

worse when walking, looks like a shuffle

abnormal or foul smelling vaginal discharge

increased pain with intercourse

fever

general malaise

n/v

nonemergency transport, detect it early to prevent infection

Pelvic inflammatory disease (PID) risks

abscesses in fallopian tube and/or ovaries —> sepsis, further infection

infertility

ectopic pregnancy

ectopic pregnancy

fertilized egg grows outside of the uterus, usually in the fallopian tube

chlamydia

risks

most common STD in US

mild/absent symptoms

can cause PID—>ectopic pregnancy

bacterial vaginosis

what is it and what age group does it affect

s&s

risks

imbalance in bacteria causing a vaginal infection in women 15-44 years, type of STD

normal bacteria in vagina replaced by an overgrowth of other bacterial forms

itchy, burning, pain, fishy foul smelling discharge

pregnant women with this may have premature babies (pH thrown off) or baby born with low birth weight

why would women have premature babies if they have bacterial vaginosis

their pH in their body is altered from a bacterial infection imbalance

gonorrhea (the clap or the drip)

caused by bacterium neisseria conorrhoeae, bacteria can grow in mouth, throat, eyes, and arms

painful urination (in men and women), burning, itching, yellowish or bloody vaginal discharge with foul odor, blood associated with sexual intercourse

types of STDs

chlamydia

bacterial vaginosis

gonorrhea

which STD causes painful urination in men and women

gonorrhea

vaginal bleeding causes

abnormal menstruation

vaginal trauma

ectopic pregnancy

spontaneous abortion

cervical polyps

cancer

spontaneous abortion

miscarriage

what to ask women about their menstruation and if they have abnormalities

when was your last cycle? do you usual get abnormal periods?

physical examinations for vaginal issues

if bleeding, what to do

should be limited and professional (only examine genitalia if necessary)

• possibly bring them into ambulance, have female EMT check if needed

visualize bleeding and ask about quality and quantity

use external pads to control bleeding

if major bleeding of vaginal issues what to do

add direct pressure with dry sterile dressing

if minor bleeding for vaginal issues

moist, sterile dressing

how to help with a female who has experienced SA

check ABC’s, give psychological care, collect evidence for it

• drugs may have been used

medical treatment, psychological care, preserve evidence

how to preserve evidence from a female who was SA

discourage urinating, changing clothes, moving her bowels, rinsing out her mouth

what to call if a female has been SA

call local rape crisis center for patient