Welcome Note
We welcome all rotating interns to our service! You will be expected to work hard, deliver babies, assist on cesareans, and triage patients in the preproom or ER! You will probably be carrying an in-hospital phone in addition to your pager. You will get all kinds of calls! You are not expected to know the answer to all the nurses' questions, but you are expected to call your resident for help when you need it!
In order to get the most out of your time on L&D, we recommend that you choose low-risk patients in labor to follow. Introduce yourself to the nurses and ask them to call you with updates. Introduce yourself to the patient. The best way to form a raport with the patient is to do the "A" sheet. This gives you a chance to get to know them. Then, when they are in active labor, write a labor progress note every 2 hours. In your note, comment on the strength of contractions, fetal heart rate, and dilation. If you have any questions, ask the OB resident on L&D. You will do the delivery with the OB Resident.
The goal is not only to learn how to deliver babies, but also how to manage labor, dose medications, learn when cesareans and amniocentesis are indicated, etc.
Goals and Objectives of Obstetrics and Gynecology Rotations
OBJECTIVES:
- Be able to perform vaginal delivery
- Be able to assist in cesarean section
- Understand management of normal labor including:
- Use of Pitocin
- When to give IV pain medications/epidural
- When to use internal monitoring (Fetal scalp electrode/Intrauterine Pressure Catheter.)
- How to identify failure to progress.
- Basic Fetal Heart Monitoring
- How to identify and manage pre-eclampsia in laboring patient.
- How to manage first trimester bleeding
- How to rule out/manage ectopic pregnancy
- How to manage hyperemesis of pregnancy and how to decide on admission criteria.
- How to manage pyelonephritis in pregnancy
- How to decide if a patient is in labor vs. Braxton hicks.
- How to use fetal fibronectin in management of threatened pre-term labor
- When to use Dexamethasone for fetal lung maturity.
- Treatment of GBS positive mothers.
- Differential Diagnosis of 3rd trimester bleeding and diagnostic tools.
- How to identify spontaneous rupture of membranes.
16. Understand post-operative course of cesarean sections.
GOALS:
- Assist or perform 15 deliveries/month. ( Including NSVD/C-Sections)
- Perform 10 first trimester ultrasounds in the prep room.
- Manage labor progress/pain medicine on 1 laboring patient per day on L&D
- Discharge NSVD/post-cesarean patients
- Identify/Rule Out Spontaneous Rupture of Membranes on 5 – 10 patients
- Evaluate Cervical Dilation on 5 -10 patients/day on labor and delivery