EPAC and GEAC

1. EPAC and GEAC Kate Palastre Jane Rideout Jenny Dixon

2. Early Pregnancy Assessment Clinic R.U.H, Princess Anne Wing, Gynaecology Outpatient Department Patients advised to attend by GP/Midwife/Nurse or may self refer. To attend between 8-9 am, weekdays.Not bank holidays.

3. Referral Criteria A positive pregnancy test!!! Up to 14/40 in pregnancy(scans usually performed from 6/40) Pain and/or bleeding. Scans not just for reassurance. Women to be stable clinically, If excessive pain/bleeding to A&E as first point of contact

4. Patient Journey Triaged by Nurse /Dr Uninalysis and preganancy test performed. Scan time allocated to patient(12 slots from 9-12.00hrs) Reviewed with scan results. If positive, home to GP/Midwife If negative, expectant or ERPC chosen. If inconclusive rescan booked, usually 1-2/52(3 per afternoon) If PUL Serum BHCG. ECTOPIC, surgery, methotrexate or conservative management.(BHCG)

5. Exclusions Women with history of Ectopic pregnancy who are symptomless should have a booked Departmental scan, by GP at 7/40. Women who have had Molar pregnancy previously and are symptomless to have booked departmental scan via GP at 8-10/40 Three consecutive miscarriages. Patients to have care planned on an individual basis .This may include a scan at appnt with Cons to discuss results of recurrent Misc Bloods.

6. Questions? Feedback? Comments?

7. Gynaecology Emergency Assessment Clinic R.U.H, Princess Anne Wing,Gynaecology Outpatients Department Patients to be referred directly from GP/Dr/Nurse to on call consultant via mobile No 07824363076 or to on call Reg. Patients to arrive at 12.00 hrs.Weekdays, no bank holidays. 3 scan slots available for this clinic

8. Referral Criteria Conditions which are unable to wait for an urgent outpatient appointment. Patients to be clinically stable, if not to A&E Eg Sudden exacerbation of pelvic pain,Bartholins/vulval Abscess, Hyper emesis gravid arum(see care plan). Bleeding/pain in pregnancy14-22/40(not usually scanned,sonicaid first), Excessive vaginal bleeding and Post op complications

9. Patient Journey Pt assessed by SHO/REG Scan booked if clinically indicated Tests performed/examined Reviewed with results Plan of care Disharged to GP care, +/- Planned F/U/Admitted

10. Questions? Feedback ? Comments?