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Referencing the content of EMT-Basic training and emergency patient care

EMT Basic · Chapter 24

Gynecologic Emergencies

Learning objectives (9)

  1. Describe the anatomy and physiology of the female reproductive system; include the developmental changes that occur during puberty and menopause — Knowledge/skills objective (printed page 881); confirm wording in your course copy.
  2. Discuss the assessment and management of a patient who has been sexually assaulted or raped; include the additional steps EMTs must take on behalf of the patient — Knowledge/skills objective (printed page 881); confirm wording in your course copy.
  3. Discuss the assessment and management of a patient who is experiencing a gynecologic emergency; include a discussion of specific assessment findings — Knowledge/skills objective (printed page 881); confirm wording in your course copy.
  4. Discuss the special considerations and precautions EMTs must observe when arriving at the scene of a suspected case of sexual assault or rape — Knowledge/skills objective (printed page 881); confirm wording in your course copy.
  5. Discuss the special, age-related patient management considerations EMTs should provide for both younger and older female patients who are experiencing gynecologic emergencies — Knowledge/skills objective (printed page 881); confirm wording in your course copy.
  6. Explain how an EMT would recognize conditions associated with hemorrhage during pregnancy — Knowledge/skills objective (printed page 881); confirm wording in your course copy.
  7. Explain the general management of a patient who is experiencing a gynecologic emergency in relation to privacy and communication — Knowledge/skills objective (printed page 881); confirm wording in your course copy.
  8. Give examples of the personal protective equipment EMTs should use when treating patients with gynecologic emergencies — Knowledge/skills objective (printed page 881); confirm wording in your course copy.
  9. List common examples of gynecologic emergencies; include the causes, risk factors, assessment findings, and patient management considerations — Knowledge/skills objective (printed page 881); confirm wording in your course copy.

Vocabulary (10)

Pelvic inflammatory disease (PID)
An infection of the upper female reproductive tract — uterus, fallopian tubes, ovaries — usually from untreated sexually transmitted infection.
Ectopic pregnancy
A pregnancy implanted outside the uterus, most often in a fallopian tube; rupture causes life-threatening internal bleeding.
Vaginal bleeding (abnormal)
Bleeding from the vagina that is not part of a normal menstrual period; can result from many causes including pregnancy complications and trauma.
Sexual assault
Any non-consensual sexual contact; a forensic and medical emergency requiring sensitive, structured EMS response.
Forensic evidence preservation
Steps that protect physical evidence — avoiding washing, discouraging changing clothes, transporting to a SANE-capable facility.
Sexual Assault Nurse Examiner (SANE)
A specially trained nurse who provides comprehensive forensic and medical care to sexual-assault patients.
Mittelschmerz
Mid-cycle, one-sided lower-abdominal pain associated with ovulation.
Dysmenorrhea
Painful menstrual cramps caused by uterine contractions during menses.
Ovarian torsion
A surgical emergency in which an ovary twists on its blood supply, causing sudden severe one-sided lower abdominal pain.
Endometritis
Inflammation or infection of the uterine lining, often postpartum.

Sequence practice (2 puzzles on Quiz Me)

EMT priorities in a sexual assault response

Order EMT priorities for an alleged sexual assault patient.

  1. Ensure scene safety; coordinate with law enforcement as appropriate
  2. Provide a private, calm setting and a same-gender provider when possible
  3. Address life-threatening injuries first; otherwise limit physical exam to what is medically necessary
  4. Discourage washing, eating, drinking, or changing clothes when feasible
  5. Transport to a SANE-capable receiving facility
  6. Document objective findings using the patient's own words; avoid speculation
Lower-abdominal pain in a person of childbearing age — EMT priorities

Order the EMT's considerations when evaluating lower abdominal pain in a person who could be pregnant.

  1. Assume possible pregnancy until proven otherwise
  2. Assess for signs of hypovolemic shock
  3. Get focused history (LMP, contraception, prior PID/ectopic, vaginal bleeding)
  4. Provide oxygen if signs of shock; position of comfort
  5. Transport with high index of suspicion for ectopic rupture

Quick fire sample (10 of 10 on Quiz Me)

An infection of the upper female reproductive tract — uterus, fallopian tubes, ovaries — usually from untreated sexually transmitted infection.
  1. Pelvic inflammatory disease (PID)
  2. Forensic evidence preservation
  3. Mittelschmerz
  4. Sexual assault
A pregnancy implanted outside the uterus, most often in a fallopian tube; rupture causes life-threatening internal bleeding.
  1. Ectopic pregnancy
  2. Ovarian torsion
  3. Sexual assault
  4. Sexual Assault Nurse Examiner (SANE)
Bleeding from the vagina that is not part of a normal menstrual period; can result from many causes including pregnancy complications and trauma.
  1. Ectopic pregnancy
  2. Ovarian torsion
  3. Vaginal bleeding (abnormal)
  4. Dysmenorrhea
Any non-consensual sexual contact; a forensic and medical emergency requiring sensitive, structured EMS response.
  1. Mittelschmerz
  2. Sexual Assault Nurse Examiner (SANE)
  3. Ectopic pregnancy
  4. Sexual assault
Steps that protect physical evidence — avoiding washing, discouraging changing clothes, transporting to a SANE-capable facility.
  1. Sexual Assault Nurse Examiner (SANE)
  2. Sexual assault
  3. Forensic evidence preservation
  4. Ovarian torsion
A specially trained nurse who provides comprehensive forensic and medical care to sexual-assault patients.
  1. Sexual Assault Nurse Examiner (SANE)
  2. Dysmenorrhea
  3. Vaginal bleeding (abnormal)
  4. Ectopic pregnancy
Mid-cycle, one-sided lower-abdominal pain associated with ovulation.
  1. Endometritis
  2. Forensic evidence preservation
  3. Ovarian torsion
  4. Mittelschmerz
Painful menstrual cramps caused by uterine contractions during menses.
  1. Sexual assault
  2. Dysmenorrhea
  3. Sexual Assault Nurse Examiner (SANE)
  4. Mittelschmerz
A surgical emergency in which an ovary twists on its blood supply, causing sudden severe one-sided lower abdominal pain.
  1. Ovarian torsion
  2. Endometritis
  3. Ectopic pregnancy
  4. Mittelschmerz
Inflammation or infection of the uterine lining, often postpartum.
  1. Pelvic inflammatory disease (PID)
  2. Dysmenorrhea
  3. Sexual Assault Nurse Examiner (SANE)
  4. Endometritis

Some topics in this course differ across field references. See when sources disagree on Quiz Me before you teach from this sheet alone.

Full scored drills are on Quiz Me at /courses/nm-emt-b/chapters/24/print/. Answers are not marked on this sheet.