Pregnancy Test Assessment - Clinica Skills - Dr Gill

Hello and welcome back to the channel. My name's Dr James Gill and you've joined me for a video on how to perform a pregnancy test. This seems like a relatively straightforward test to do. However, it's actually very important from a medical legal perspective. Anybody of child-bearing age who has abdominal pain really should have a pregnancy test to exclude pregnancy as a potential source of that pain. Now, the pregnancy test is an investigation. It's a test. Therefore, we need to make sure we've got consent before we do so. I would always offer a pregnancy test to a patient of child-bearing age who has abdominal pain even if they're saying they're not sexually active because I can rule it out medically legally. If the patient declines to have that test done, that's entirely valid. They have that autonomy to do so. But I would explain my reasoning for why I wanted to exclude that test. In terms of doing it, we want to make sure we're covering ourselves. So, we're making sure we're wearing gloves. We're going to provide the patient with a urine bottle and have them bring that sample back to us in an ideal situation. The reason being is the patient has given us that sample and then we have chain of custody. We can take it and get it assessed. In terms of assessing it, we want to check that the pregnancy test is within date and crucially is sealed. We also want to have a look at the instructions on that particular test. Some tests are designed for patients to urinate on but can also be used to put in a urine sample. Some tests are only to be put in the urine sample. When we've got the urine from the patient, we're going to take it to the sink here and I would recommend that we do a urine dipstick to look for other causes of the pain in the urine. For example, a positive urine dip for an infection which might suggest leukocytes, nitrites, blood. We can also see other things like dehydration which will be shown with ketones and potentially glucose that might make us open up our differentials again. Once we've covered that hurdle, then we want to do the pregnancy test. We're going to apply the pregnancy test to the urine sample and we're going to watch for the control line to appear. In terms of doing the pregnancy test, we've made sure that the sample is from the correct person. In this particular case, the patient has handed it to me. So I'm going to open the top, the clinical sample again. We're double-checking the pregnancy test is in date and sealed. So the pregnancy test is opened and you can have some tests that can actually the patient can urinate on and others that you can dip. In this case, this one can be used in both ways. So we're dipping down to the urine and we're giving 10 seconds. Then we're bringing it up. We can see all four squares have been hydrated and the test strip is taking the fluid up and we're putting the end over. At which point, we put the test strip horizontally and leave it for one minute but already you can see that two lines are developing rapidly here. So if there's any doubt, you're going to make sure you give the whole 60 seconds and then return to the patient. Once we've dipped the urine, we're going to place the test strip on a horizontal surface and we're going to observe it for 60 seconds. In that time, we'd expect the control stripe to appear showing that the test is valid and then if we have the patient carrying a pregnancy, we'd expect a second line indicating a positive test result. If we're only getting one line, the test, the control strip, then we've got a negative test result and we can inform from this the patient is not pregnant at that stage to the sensitivity of that test strip. I would always recommend taking the positive pregnancy test back to the patient so they can see that positive test result because sometimes it's a thing that a patient would be want to double check and see those results for themselves and sometimes people would want to be able to take it away as well. In all state cases, I would always advise the patient that they can repeat the test themselves if they've got any doubt. Hopefully, that's been useful and if you'd like to follow along for more advice on how to perform clinical medicine, see if we can help. Take care and we'll see you in the next one. Cheerio.