Raleigh Consult Workflow + ED Follow-up + OB Transfer

Reasons to go into Raleigh:

• •Hemorrhagic cyst, hemodynamically unstable.
• •Confirmed or suspected ectopic.
• •Ovarian torsion.

Patients not appropriate for discharge home — Hospitalist Medicine service:

• •Hospitalist medicine is first call.
• •Round on patient in the AM. GYN is considered a consult service at Raleigh → write good notes because they follow them.
• •Be clear about what meds need to be discontinued upon discharge.
• •Pads count, vitals intervals, CBC repeat 4–6.
• •Obs scenarios: Hgb drop 11 to 8, PID with need for IV antibiotics.

Going to the OR:

• •Post and consent the patient after talking to the attending.
• •Let the OR charge RN know so they can call anesthesia to come in.
• •DRH OR control desk #3: (919) 954-3299

First call inpatient only when Urogyn/MIGS admits someone post-op or rarely an Onc case. Admit to GYN. Responsible for all nursing messages, including overnight.

ED non-onc/urogyn GYN follow-up:

Any patients in the ED without an established GYN (non-onc or urogyn) can follow up with Dr. Garcia — including fibroids and endometriosis. Message her and Navaho front desk in MyChart.

• •Emphasize not conducting any workup that will delay transfer.
• •While awaiting transfer can collect CBC, Coags → inform GYN for awareness if fibrinogen <200.
• •For OB, Heritage and Durant Road division see OB patients that want to stay in Raleigh or Wake Forest, or they can go to Durham or 1J.