<16 WEEKS (ED ALGORITHM)
1 INITIAL ASSESSMENT
Pain • bleeding • collapse • shoulder-tip pain • GI symptoms → THINK ECTOPIC
Complete: Urine pregnancy test • observations • stability • brief history + ectopic risk factors
2 ASSESS STABILITY
UNSTABLE
ABCDE
2 x IV cannulas
FBC/U&E/LFT/G&S ± crossmatch & serum β-hCG
Fluids/blood
URGENT GYNAE REVIEW
DO NOT transfer to EPAU before stabilisation.
STABLE
Discuss with EPAU – SAME DAY.
Then apply traffic-light triage below.
3 TRAFFIC-LIGHT TRIAGE
4 ED RULES
✓ DO
Urine pregnancy test
Assess stability
Consider ectopic
Discuss symptomatic patients with EPAU
Safety net
✕ DO NOT
Routinely request serum β-hCG in stable patients
Use β-hCG to decide scans
Promise scan times
Exclude ectopic because observations are normal
5 SAFETY NET
RETURN IMMEDIATELY to CRH
If: collapse, worsening pain, shoulder-tip pain, heavy bleeding, new symptoms, feeling unwell
KEY MESSAGE
Positive pregnancy test + pain/bleeding + NO confirmed intrauterine pregnancy
= ECTOPIC PREGNANCY REMAINS POSSIBLE UNTIL PROVEN OTHERWISE
