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Microsoft word - medical termination of pregnancy.doc

MEDICAL TERMINATION OF PREGNANCY
A medical termination of pregnancy can be done up to week nine of the pregnancy. It iscalled a medical termination because it uses tablets to cause the termination rather thanan operation.
What does it involve?
A medical termination is a two stage procedure. For legal reasons both stages have to
take place at a designated hospital or clinic.
Stage 1 of the Termination of Pregnancy
How does it work?You will be asked to attend the hospital and take tablets called Mifepristone also called(Mifigynae). These tablets block the action of the natural hormone progesterone.
Progesterone is produced by a woman in increasing amounts in the early stages ofpregnancy. It is needed to keep the pregnancy attached to the lining of the uterus (womb).
When you take Mifepristone it prevents the progesterone from dong this and thepregnancy detaches itself from the womb and dies. The Mifepristone also has an effect onthe cervix (neck of the womb) causing it to start to open and on the muscular wall of theuterus making it likely to contract.
You can experience some side effects from Mifepristone, which can include: Feeling faintNausea/vomitingSkin rashBleeding/crampsCollapse The nursing staff will record your pulse and blood pressure while you are on the ward. Youwill stay on the ward for 1 to 2 hours. Before you go home your next appointment will beconfirmed with you. This will be two days later. The ward contact telephone number, ifyou have any questions or problems before your next admission is Ward 12: 01274364380 (24 hours). If you vomit within 2 hours of taking the Mifegynae you should contactWard 12 for advice.
Ward 12 is a female ward with ladies having a variety oif gynaecology operations. Due tothe limited space and to respect other patients diginity and confidentiality it is not possiblefor anyone to stay with you or wait in the ward area while you are in hospital. Your visitorsare welcome to return to see you at visiting times, as follows: We request that you have no more than 3 visitors at any one time.
You may experience cramp like pains or bleeding before you return for Stage 2 of thetermination. If you do pass any large blood clots or lumps before you are due to beadmitted, please try to save them and bring them to the hospital with you to give to thenurse who admits you. You can take medication for the pain whilst at home, Paracetamolor Ibuprofen can be taken as directed on the packet.
You are welcome to bring someone with you for support throughout the whole process,however, due to limited space on the ward, we request that you have just one person withyou and you do not bring any children with you.
Stage 2 – of the Termination of Pregnancy
You will be asked to return to Ward 12 two days later. Please bring with you someslippers, dressing gown, toiletries and sanitary towels A nurse will show you to a bed, explain the next stage of the procedure with you in casethere is anything you are unsure of, she will also discuss any symptoms you may haveexperienced since you left the ward.
When you are in hospital it is essential to wear a wristband at all times to ensure yoursafety during your stay.
The wristband will contain accurate details about you on it including all the essentialinformation that staff need, to identify you correctly and give you the right care. All hospitalpatient including babies, children and older people should wear the wristband at all times.
If you do not have a wristband whilst in hospital, then please ask a member of staff forone. If it comes off or is uncomfortable, ask a member to staff to replace it.
When you have settled in a nurse will place four small tablets called Misoprostol high upyour vagina to your cervix (neck of the womb).
After the tablets have been inserted you will be asked to remain on your bed for an hour.
These tablets will cause the cervix to open and expel the pregnancy. You will havecontractions of your uterus (womb) and experience some pain, like a strong period pain.
You may have pain killers to relieve this. You may also have nausea, vomiting ordiarrhoea you may also have medication to help relieve this.
You will have vaginal bleeding which may be heavy. It is important that the nursing staffcheck what you pass vaginally so the progress of your termination can be monitoredtherefore when you visit he toilet a container will be provided for your useIf you have not delivered the pregnancy after three hours, further Misoprostol tablets willbe inserted in your vagina. This stage usually takes up to six hours.
You will be discharged home when the nurse is satisfied that the termination is completeand you are well enough to go home. You will be offered a form of contraception, such asthe Oral Contraceptive Pill or Depo Provera (information leaflets will be provided). It is veryimportant that you use a reliable method of contraception to prevent an unwantedpregnancy.
You are advised not to drive home yourself.
A follow up appointment may be given to return to the Lilac Clinic. A letter will be sent toyour GP to inform them of the Termination of Pregnancy (if you do not wish your GP to beinformed, please inform the nurse caring for you).
If you have any questions or concerns at any time, please ask the nursing staff who willdiscuss these with you.
Contact telephone numbers for advice:
Ward 12- 01274 364380 (24 hours).
Author: Maureen Jones Deputy Ward Manager Ward 12Review date – April 2009

Source: http://www.bash.nhs.uk/file_download/21/Medical+Termination+of+pregnancy.pdf

Microsoft word - travel health questionnaire new toronto _3_.doc

Travel Health Clinic You must remain in the clinic for 20 minutes following any vaccination. Date: ___ / ___ /_____ (DD/MM/YYYY) Chart #: _____________ Health insurance #:____________________ PATIENT INFORMATION (To be completed by the traveller) Vaccines, medications and other travel recommendations will be tailored to suit your needs based on your responses. Gender:  Male

Instructions

Name:_____________________________________________________ Date of Birth_____/_____/_____ Age_______ Sex M F Address:____________________________________________________ City:____________________State:_________ Zip:___________ Hm Phone:_________________________________________________ Wk Phone:____________________________________________ Cell Phone:____________________________________________

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