This document is a summarised version of Women’s Services DP-CC4-Management of Early Pregnancy Complications and OP-GC7-Sunshine Hospital Emergency Department – Model of Care Guideline – Emergency Department Obstetrics and Gynaecology Registrar. The summary has been created to be Emergency Department specific, and has been endorsed by the ED Leadership Team. Staff should review the PPG’s if they require further information.
This QRG provides an overview of the Emergency Department Obstetrics and Gynaecology (EDOG) Registrar service within the SHED.
This QRG is applicable to clinical staff working in the SHED and to O&G staff at Sunshine Hospital.
The Heads of Unit Obstetrics and Gynaecology, SHED Nurse Unit Managers, and Adult Director and Deputy Director of Emergency Medicine are responsible for implementing the EDOG guideline.
What is the EDOG service?
The EDOG service is a specialist obstetric and gynaecological (O&G) service within the SHED environment, providing timely assessment and treatment for women presenting with O&G complaints, typically early pregnancy (<16 weeks) and gynaecological conditions.
Pregnant women >16 weeks gestation and up to 6 weeks post-partum with pregnancy related complaints will present directly, or will be redirected at Triage, to the Maternity Assessment Centre (MAC) in the Joan Kirner Women’s and Children’s (JKWC) unless unstable.
Location and operating hours
Whilst this service does not currently have a designated clinical space within ED, where possible SSU 1 should be prioritised for use by the EDOG team.
Figure 1: Location of the EDOG service within SSU
Figure 1: Location of EDOG service within SHED SSU
The service operates 1200 – 2030, seven days per week. Outside of these hours, women presenting with O&G complaints are assessed and treated in an appropriate clinical space within the ED by ED medical and nursing staff, with escalation and clinical support available via the on-call O&G registrar.
The service is staffed by an O&G registrar/senior HMO/HMO, supported by the SSU medical and nursing staff, and the on-call O&G senior registrar or consultant.
Inclusion criteria – EDOG referral direct from Triage*
- COVID-19 low risk classification
- Early pregnancy (≤16 weeks gestation)
- Complications of recent early pregnancy (<16 weeks)
- Existing gynaecological diagnosis and related acute episode
- Abscess – labial/bartholin
- Postnatal patient (<6 weeks postpartum) – refer to the MAC at Triage unless unstable
*Women presenting with non-specific symptoms with a high likelihood of gynaecological condition, and pregnant women presenting with non-pregnancy related conditions must first be reviewed by an ED medical officer prior to referral to the EDOG.
Staff should identify patients suitable for the EDOG service by writing EDOG at the start of the Handover comments in EDIS. This ensures patients are easily identifiable on the EDIS tracking screen.
Inward pathways to receive EDOG care
- Presents to ED during EDOG hours, Triaged as O&G, Referred directly to EDOG
- Presents to ED, Triaged as non-specific, possible O&G, Assessed by ED medical officer, Referred to EDOG
- EDOG & Emergency Physician review entire waiting room list following triage, Selects and reviews patients identified as O&G
- Presents to MAC, Assessed as not suitable for MAC, Redirected to ED
Outward pathways for EDOG care
- Discharged home/to usual place of residence
- Admitted to the O&G inpatient ward
- Referred to the Early Pregnancy Assessment Service (EPAS) in JKWC
- Referred to Gynaecology Specialist Outpatient Services
- Handover to the night O&G team
||Emergency Department Obstetrics & Gynaecology Registrar (EDOG) – SHED
|Date of scheduled review:
|SHED Leadership Team
||SHED Leadership Team