For a given center, the obstetrics department, in conjunction with the other appropriate departments, should establish written guidelines defining the appropriate unit to evaluate obstetric patients based upon criteria such as gestational age and delivery status, symptoms, medical condition, and available medical staff. For instance, some nonobstetric conditions eg, highly transmissible infectious diseases like influenza or varicella, critical traumas, and acute chest pain may be better treated in another area of the hospital, regardless of gestational age.
Conversely, many postpartum conditions may be best addressed by labor and delivery staff. Disaster preparedness plans should include care of pregnant women 3. For all of these reasons, coordination and communication between obstetric and emergency departments, as well as hospital ancillary services, is critical 3.
Emergency departments should consider early consultation with obstetric care providers when triaging and managing pregnant patients, especially for patients beyond the first and early second trimesters. To be considered an appropriate location to evaluate and care for pregnant patients, a unit should have the ability to perform basic ultrasonography and fetal monitoring. In cases that involve a woman with a viable pregnancy who is evaluated outside of an obstetric unit, it may be necessary to bring these resources from the obstetric unit to the location of the patient.
Triage algorithms for obstetric acuity to assess and assign priority to obstetric patients may be useful. Women should be cared for according to triage acuity rather than by time of arrival.
The Emergency Severity Index was designed by the Agency for Healthcare Research and Quality to triage nonpregnant adults and has been adopted by many emergency departments 8. Several obstetric triage acuity tools have been developed based on this model. Several of these tools have been tested for content validity 10 and interrater reliability 11 , 12 and may be used to improve quality and efficiency of care and guide allocation of resources.
Hospital obstetric units are encouraged to develop triage protocols based on local conditions but informed by evidence-based decision making. Examples are trauma from motor vehicle accidents, falls, and intimate partner violence. The MFTI is designed to guide clinical decision-making but does not replace clinical judgment.
Vital signs in the MFTI are suggested values. Values appropriate for the population and geographic region should be determined by each clinical team, taking into account variables such as altitude.
Figure 1. Maternal—fetal triage index. Content validity testing of the maternal fetal triage index. J Obstet Gynecol Neonatal Nurs ;—9. The American College of Obstetricians and Gynecologists has identified additional resources on topics related to this document that may be helpful for ob-gyns, other health care providers, and patients.
You may view these resources at www. These resources are for information only and are not meant to be comprehensive. The resources may change without notice.
All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, posted on the Internet, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without prior written permission from the publisher. Hospital-based triage of obstetric patients. Committee Opinion No. American College of Obstetricians and Gynecologists.
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The specific requirements or preferences of your reviewing publisher, classroom teacher, institution or organization should be applied. Numerous documentation issues also need to be addressed in triage. By setting time and language limitations, a search for Persian and English articles published in the period from to was performed in Scopus, Google Scholar, Scientific Information Database, ProQuest, Medline, Embase and Web of Science databases. Print version: Angelini, Diane J. In addition, the office of the Inspector General has the authority to execute facility and practitioner fines Glass et al. This information will enable practitioners to easily recognize and understand symptomatology, lab results, diagnostic imagery and clinical workings. Your request to send this item has been completed.
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