If your patient responds well and quickly to IV antibiotics and bedrest, you may safely continue your treatment. Remember, though, that she has the potential for becoming extremely ill very quickly and transfer to a definitive care facility should be considered. IV antibiotics should be started immediately. Right shoulder pain suggests substantial blood loss. Sensitive pregnancy tests are almost invariably positive.
Treatment is immediate surgery to stop the bleeding.
If surgery is not an available option, stabilization and medical evacuation should be promptly arranged. Keep the patient at absolute rest. Monitor urine output hourly with a Foley catheter. Take frequent vital signs to detect shock. If abdominal surgery is not available, the outlook for a patient with a ruptured ectopic pregnancy is not totally bleak.