History

Presentation context

Postpartum infection context

Symptom inventory

Symptom timeline

OPQRST

Pain OPQRST

Prior episodes and baseline

Baseline postpartum recovery

Exposure and procedure history

Recent procedures

Infectious exposures

Alarm Features

Immediate escalation triggers

Sepsis and shock features

Necrotizing infection features

Pulmonary embolism features

CNS infection features

High risk postpartum syndromes

Toxic shock and invasive GAS features

Septic pelvic thrombophlebitis features

Wound and perineal danger findings

Cesarean wound complications

Perineal infection complications

Medications

Current and recent medications

Medication list

Allergy profile

Breastfeeding considerations

Lactation status

Infant factors

Diet

Hydration and intake

Intake pattern

Hydration indicators

Exposures

Foodborne exposure context

Caffeine and energy drinks

Review of Systems

Constitutional and infectious

System review

Cardiopulmonary

Cardiopulmonary symptoms

GI and GU

GI and GU symptoms

Breast and skin

Breast and skin symptoms

Neuro

Neuro symptoms

Collateral History and Family History

Collateral and supports

Collateral sources

Family history relevant to complications

Family risks

Risk Factors

Obstetric and intrapartum risks

Endometritis risk factors

Wound infection risk factors

Thrombosis risks

VTE risks

UTI and device risks

UTI risks

Breast and lactation risks

Mastitis risks

Exposure risks

Community infection risks

Differential Diagnosis

Life threatening

Life threatening causes

Common

Common causes

Less common and mimics

Past Medical History

Relevant baseline conditions

Comorbidities

Prior obstetric and surgical history

Prior history

Baseline functional status

Baseline

Physical Exam

Vitals and general

Initial assessment

Hemodynamic and respiratory

Cardiopulmonary exam

Abdomen and pelvis

Abdominal and pelvic exam

Speculum and bimanual exam considerations

Wounds and skin

Wound exam

Perineum

Breast

Breast exam

Extremities and neuro

VTE screen

Neuro exam

Lab Studies

Sepsis and infection workup

Core labs

GU testing

Urine testing

Gynecologic and wound testing

Source directed studies

Other labs by scenario

Additional labs

Imaging

Scoring Systems

Sepsis tools

MRI

MRI pelvis considerations

CT

CT indications

CT pulmonary angiography

Ultrasound

Pelvic ultrasound

Breast ultrasound

Special Tests

Bedside and procedural diagnostics

Bedside evaluation adjuncts

Microbiology and targeted tests

Targeted testing

ECG

Indications and high risk patterns

ECG indications

High risk findings

Assessment

Working syndromes

Postpartum febrile illness framework

Severity stratification

Key complications to rule out

Cannot miss complications

Plan

First 5 minutes and stabilization

Critical pathway

Empiric antibiotics by suspected source

Uterine source

Cesarean wound or cellulitis

Necrotizing infection concern

Mastitis outpatient

Pyelonephritis

Source control and consultations

Source control

Consultation triggers

Monitoring and reassessment loop

Reassessment loop

Disposition

Level of care criteria

ICU criteria

Inpatient admission criteria

Observation pathway criteria

Discharge criteria

Discharge Instructions

Copy discharge instructions

Summary

Medications

Activity

Follow up

Return to ED now for

References

Guidelines and key sources

ACOG Committee Opinion

ACOG Practice Bulletin

CDC

Surviving Sepsis Campaign

IDSA

ABM Academy of Breastfeeding Medicine Protocol