A 29-week pregnant patient arrives at the ED saying her water has broken. What should you do?

In the scenario presented, the most appropriate action for a 29-week pregnant patient who has had her water break is to transfer her to a tertiary facility. When a patient's membranes rupture prematurely, especially before 34 weeks of gestation, it poses significant risks including preterm labor, infection, and complications associated with underdeveloped neonates.

Tertiary facilities are equipped with specialized neonatal intensive care and obstetric resources that can best manage both the maternal and neonatal needs. Early transfer to a facility that can provide comprehensive care helps ensure the best possible outcomes for both the mother and the baby.

While contacting the OB/GYN, admitting to labor and delivery, or consulting a nurse midwife are important steps in managing such cases, these options do not provide the level of immediate specialized care that a tertiary facility can offer in the event of complications associated with preterm labor or premature rupture of membranes. Hence, transferring the patient ensures access to the necessary expertise and facilities to handle potential emergencies effectively.