Obstetrics, Gynecology, and Pediatric Emergencies
Core concepts
For obstetrics, understand normal labor stages, assessment of imminent delivery, and management of the newborn (warming, drying, stimulation, suctioning only if needed, and PPV if apneic). Know the recognition and management of postpartum hemorrhage, preeclampsia/eclampsia, and shoulder dystocia. For gynecology, understand ectopic pregnancy, sexual assault response, and abdominal pain assessment. For pediatrics, know age-specific vital signs, weight estimation, pediatric assessment triangle, and common emergencies such as croup, epiglottitis, bronchiolitis, febrile seizures, and dehydration. Understand pediatric dosing and the smaller margin for error.
Traps in questions
Common traps include delaying transport for an imminent delivery, failing to warm and dry the newborn, or giving too much fluid to a child. Questions may present a pregnant patient with abdominal pain and ask about ectopic pregnancy-consider it in any woman of childbearing age with abdominal pain and syncope. Be careful with croup versus epiglottitis: epiglottitis is a true airway emergency with drooling and tripod positioning.
Rule of thumb
For imminent delivery, prepare the field, support the perineum, and control the head as it delivers. For the newborn: warm, dry, stimulate for the first 30 seconds; if still apneic, begin PPV. For any woman of childbearing age with abdominal pain and syncope, consider ectopic pregnancy.