Procedures / NF Handoff

• •L&D Manager tab for scheduled procedures.
• •Can prep daily for cases during the work day or prep in advance (some cases may be added / delivered if prep early).
• •Use most recent prenatal note and initial prenatal note to find key info.
• •Do the pre-op orders.
• •If Hgb >9 → no need to type & cross for 2 units.
• •If diabetic: POC glucose.
• •Cerclages: clarify history-indicated, U/S-indicated, rescue. Just do pre-op orders, no antibiotics.
• •Chart review: genetic testing results.
• •ECV: Terbutaline 0.25 mg.

In between cases, check in with AP to see if you can help with tasks.

AP Pre-rounding:

• •For people who are rocks: say hey, do brief physical exam, tell them you’ll come around with the big team later.
• •For active people or news: take more time to be thorough pre-rounds.

3rd year is Procedures resident — you need to KNOW everyone on the list:

• •Present who you rounded on after PGY-3 gives their sign out.
• •Table rounds first with Attending / Fellow / APP.
• •List usually 8–12 people; tend to round on 5–6 daily.
• •You split the list — APP, PGY-3, yourself.
• •Residents cap at 6 each, then APP gets assigned.

Walking Rounds: for people you know well, you tell them about their plan. APP will place orders with laptop during in-person rounds.

Call consults after rounds.

Tips:

• •Have a good 1-liner about each patient. E.g., “28 wk PPROM HD-35, BMZ complete, getting AFI today.”
• •Arrival: 5:30 AM in the beginning / when there are new people. New patients 15–20 min; old patients 5–10 min.
• •PM Sign Out: GYN workroom at 6 PM. You sign out on Thursdays.

Get sign out 6 PM in GYN workroom from AP and all GYN services.

Cover AP and Gyn Onc services → call into pagers.

• •Go to consults / leveled cases if not in sections.
• •Can help in triage when things are in a good place.
• •May need to scrub out day team from cases, so have green scrubs ready.
• •Check vitals q3–4 hours.
• •If you see a patient for an assessment overnight or if you go to RRT, drop a note.
• •Text oncoming teams at 0430 to let them know about any news. Also update patient handoffs in charts throughout the night.

• •Time:
• •Procedure:
• •OB Provider:
• •Name:
• •AGE/GP/GA: X y/o GXPX @ X’x
• •Pregnancy complications:
• •OB Hx:
• •PSH:
• •Meds: exclude non-relevant things (i.e., PNV)
• •BMI:
• •Anatomy US — normal fetal anatomy / placenta
• •Fetal ECHO:
• •Last growth — extrapolates to:
• •Hgb: if not within a week, say no recent labs
• •PLT:
• •Allergies:
• •Contraception:
• •To do / FYI:
• •Orders:

• •We will now use Cefazolin for GBS prophylaxis in place of penicillin (equal efficacy, uses less fluid for antibiotic prep).
• •All amnioinfusions need to use NORMAL SALINE, not LR.
• •Scenarios for which we previously would hang an accompanying IV fluid, but is NO LONGER needed: mag sulfate administration, oxytocin administration, antibiotic administration, and blood product transfusion.