Intern Ready: Ob/Gyn

Before Your First: Benign GYN ED Consults

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Your pager goes off — the ED has a GYN consult. Now what? In this episode, we walk through exactly how to triage, evaluate, and staff a benign gynecology consult in the emergency department, from the moment you get the call to closing the loop with your team.

Topics Covered:

  • Triage Procedures
    • Logistics: Know the ED layout — pelvic exam rooms, supply locations.
    • Clinical Assessment: Determine hemodynamic stability, active bleeding, starting hemoglobin, and the consulting physician's level of concern.
    • Hemodynamically Unstable Patients: Immediate bedside evaluation. Coordinate 2 IVs, Type and Screen/Cross, coags, bedside FAST exam, and NPO status for potential surgery.
    • Hemodynamically Stable Patients: Chart check, review imaging (TVUS), read up on the differential (UpToDate, ACOG), and inform your senior team.
    • Patient Evaluation
      • Introduce the GYN team and provide context to the patient.
      • Gather a full history: HPI, PMH/PSH/OB-GYN history, medications, allergies, social history, and barriers to follow-up.
      • Prepare supplies for the physical exam (bed pans, speculums, swabs, cultures) and ensure proper lighting.
      • Obtain necessary consents (including blood consents if relevant) before staffing.
      • Staffing the Consult
        • Stay organized — use your notes and outline the case.
        • "Don't bury the lead" — start with a clear one-liner on assessment and disposition (medical management vs. surgical intervention).
        • Developing an Assessment and Plan
          • Own it — formulate an independent assessment and plan, not just a data report.
          • Present reasonable management options (medical vs. surgical) to the attending.
          • Place the patient on the team handoff list.

            • About the Speakers:

            Host: Lucy Brown, MD, MPH – Resident physician at Johns Hopkins GYN/OB. Dr. Brown is passionate about medical and resident education and will be pursuing a Fellowship in Complex Family Planning after residency.

            Guest Speaker: Jennifer Doorey, MD, MS – Academic Ob/Gyn at The Johns Hopkins University School of Medicine. As the founder of MedReady, Dr. Doorey seeks to advance clinical medical education by developing resources for medical students and clinical educators.

            Intern Ready: Ob/Gyn is a podcast aimed at interns and off-service residents beginning their post-graduate training in Obstetrics and Gynecology. The views expressed are the speakers' own and do not constitute medical advice.

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            Intern Ready: Ob/GynBy Lucy Brown, M.D.