Term
| History of Presenting Complaint |
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Definition
Timing of unprotected sexual intercourse (UPSI).
Clarify consensual nature sensitively. |
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Term
| Medical & Medication History |
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Definition
Past/current contraceptive use.
General medical history and allergies. |
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Term
| What gynaecological history is needed? |
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Definition
Previous pregnancies or emergency contraception use.
Menstrual cycle details (last period, regularity). |
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Term
| What social/sexual history should be confirmed? |
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Definition
Smoking, alcohol, or drug use.
Recent sexual partners and STI screening history. |
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Term
| Explanation of Options: What emergency contraception options are available, and what are their timing requirements? |
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Definition
Ulipristal acetate: Up to 120 hours (5 days) post-UPSI.
Copper coil: Up to 5 days post-UPSI. Levonorgestrel is only effective up to 72 hours post-UPSI |
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Term
| What counselling points are key for efficacy/side effects? |
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Definition
Compare efficacy: Copper coil > ulipristal.
Discuss side effects (e.g., nausea, irregular bleeding). |
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Term
| How would you address ongoing contraception needs? |
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Definition
| Encourage copper coil if patient desires long-term contraception. |
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Term
| What education should be provided? |
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Definition
Promote STI screening.
Advise safe practices (e.g., condom use) |
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Term
| What safety advice and referrals are needed? |
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Definition
Advise to seek help for severe pain/bleeding.
Arrange same-day sexual health appointment for coil insertion. |
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Term
| How might you adapt communication for a patient with a learning disability? |
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Definition
Use simple, jargon-free language.
Visual aids (e.g., timelines, pictures of contraception options).
Check understanding frequently (e.g., "Can you tell me what we just talked about?"). |
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Term
| How would you assess capacity to consent to emergency contraception? |
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Definition
Ensure the patient understands the treatment, risks, and alternatives.
Use supported decision-making (e.g., involve a trusted caregiver if needed). |
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Term
| What safeguarding actions are needed if UPSI was non-consensual or coercion is suspected? |
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Definition
Follow local safeguarding protocols. Inform seniors to discuss the need to inform the safeguarding lead.
Involve multidisciplinary team (e.g., social worker, safeguarding lead). |
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Term
| What follow-up arrangements are important? |
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Definition
Confirm date of next menstrual period.
Pregnancy test if period is delayed by >7 days.
Review ongoing contraception needs. |
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Term
| How would you address misconceptions about emergency contraception? |
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Definition
Clarify it does not cause infertility or harm future pregnancies.
Emphasize it is not abortion. |
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Term
| How might cultural/religious beliefs impact decision-making? |
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Definition
Ask sensitively: "Is there anything important to you that I should consider?"
Tailor options (e.g., copper coil may conflict with certain beliefs). |
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Term
| What practical barriers might this patient face? |
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Definition
Transportation to sexual health clinic for coil insertion.
Difficulty remembering to take oral contraception. |
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Term
| When/how to involve a caregiver or advocate? |
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Definition
Ask patient’s permission first.
Share only relevant information to protect confidentiality. |
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Term
| What if the patient is under 16? |
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Definition
| Follow Fraser Guidelines (UK): Assess competence, explore coercion, encourage parental involvement unless unsafe. |
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Term
| How to address anxiety about copper coil insertion? |
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Definition
Explain the procedure step-by-step.
Offer pain relief (e.g., NSAIDs) or local anaesthetic. |
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Term
| What broader health topics are relevant? |
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Definition
Cervical screening eligibility.
Vaccinations (e.g., HPV, hepatitis B). |
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Term
| What documentation is essential? |
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Definition
Detailed consent process.
Safeguarding concerns and actions taken.
Patient’s understanding and preferences. |
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Term
| How to explain the menstrual cycle’s relevance to emergency contraception? |
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Definition
Use simple terms: "Emergency contraception works best if you’re not ovulating (releasing an egg)."
Link timing to last menstrual period. |
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Term
| How to reassure an anxious patient? |
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Definition
Normalize feelings: "It’s okay to feel worried."
Focus on empowerment: "We’re here to help you stay safe." |
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