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Thursday, April 11, 2019

Speculum in the ED

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emDocs - April 8, 2019 - Authors: Christophe K and Silverberg M 
Edited by: Koyfman A and Long B
"Key points
  • Pelvic exam findings are highly subjective.
  • Accuracy of pelvic exam results may vary depending on patient body habitus.
  • Absence of adnexal mass and/or lack of severe pelvic tenderness does not rule out ovarian torsion.
  • Pelvic exam should not be relied on to rule out sexually transmitted infections.
  • Patient-collected vaginal swabs or urine specimens are acceptable and accurate for STI testing.
  • Pelvic exam cannot reliably rule out ectopic pregnancy.
  • When ultrasound is performed in patients with early pregnancy complaints, the pelvic exam is unlikely to change patient disposition.
  • Engage patients in shared decision making when you are questioning the utility of a pelvic exam."