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Workflow pack

Pelvic pain risk-stratified workflow

Workflow for pelvic pain visits prioritizing pregnancy/infection red flags and timely escalation pathways.

Trust and governance

Use only within this workflow's defined scope and exclusions.

Last reviewed

2026-02-07

Clinical owner

Family Medicine Editorial Team

Risk tier

Medium

Review cadence

Every 6 months

Next due 2026-08-07

Review status

Current

Scope limits

Initial outpatient pelvic pain triage in clinically stable patients.

Exclusions (escalate/redirect)

  • Hemodynamic instability, severe hemorrhage, or suspected surgical emergency.
  • Inpatient emergency gynecology management.

Escalate-now emphasis (medium-risk workflow)

Treat red-flag findings as urgent. Escalate the care pathway early if concern persists or follow-up reliability is uncertain.

At a glance

Rapid decision framing for in-visit use. Educational only; always apply clinical judgment.

Immediate actions

  • Define pain severity/pattern and associated urinary, GI, and bleeding symptoms.
  • Screen immediately for pregnancy-related and infectious high-risk causes.
  • Determine disposition safety before proceeding with outpatient plan.

Red flags / escalate now

  • Severe escalating pain with instability, syncope, or heavy bleeding.
  • Concern for ectopic pregnancy, torsion, or severe pelvic infection.
  • Worsening symptoms with unreliable follow-up capacity.

First-line plan

  • Use risk-guided testing and focused initial management.
  • Provide clear rationale for outpatient versus urgent referral pathway.
  • Document explicit escalation thresholds.

Follow-up and monitoring

  • Set short-interval reassessment if diagnosis remains uncertain.
  • Escalate for worsening pain, fever, bleeding, or instability.
  • Ensure return precautions are communicated in plain language.

Next useful actions

Keep moving without restarting the search.

These are the most likely next clicks after opening this workflow.

Condition guidance

Referral checklists

Tools and calculators

Return precautions (patient script)

Suggested plain-language wording for safety-net counseling:

If symptoms get worse, new warning signs appear, or you cannot follow the plan from this visit, seek urgent care now.

  • Use with the specific red flags listed on this page.
  • Confirm follow-up timing and where to go after-hours.
  • Document that return precautions were reviewed and understood.

Visit-close checklist

  • Document disposition, rationale, and unresolved diagnostic uncertainty.
  • Give explicit return precautions and follow-up timeline before ending visit.
  • Attach a relevant handout when available to reinforce adherence and safety-netting.