Sexually Transmitted Infections (STI) in Adolescents Clinical Pathway — Emergency Department and Primary Care

Nursing Considerations

Pain	Assess, treat as indicated
Urine Testing	Notify T7 Attending/FLOC if STI testing indicated Dirty specimen: GC/Chlamydia/trichomoniasis Clean specimen: HCG, POC testing HCG if age > 12 years or menarche
Pelvic US	Notify T7 Attending if chief complaint is abdominal pain Recommend NPO if concern for surgical etiology US may be required, instruct patient NOT to urinate after HCG sent Discuss bladder filling, if no concerns for surgical etiology Provide fluids, instruct patient to drink 12 oz every 10 min over 30 min Instruct patient to hold urine Ask patient to contact RN when bladder feels full RN completes US bladder volume Contacts US if full volume (> 250 mL)

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The clinical pathways are based upon publicly available medical evidence and/or a consensus of medical practitioners at The Children’s Hospital of Philadelphia (“CHOP”) and are current at the time of publication. These clinical pathways are intended to be a guide for practitioners and may need to be adapted for each specific patient based on the practitioner’s professional judgment, consideration of any unique circumstances, the needs of each patient and their family, and/or the availability of various resources at the health care institution where the patient is located.

Accordingly, these clinical pathways are not intended to constitute medical advice or treatment, or to create a doctor-patient relationship between/among The Children’s Hospital of Philadelphia (“CHOP”), its physicians and the individual patients in question. CHOP does not represent or warrant that the clinical pathways are in every respect accurate or complete, or that one or more of them apply to a particular patient or medical condition. CHOP is not responsible for any errors or omissions in the clinical pathways, or for any outcomes a patient might experience where a clinician consulted one or more such pathways in connection with providing care for that patient.