ATLS pregnancy Flashcards
What is the best initial treatment for the fetus in a trauma case?
Care of the mother
When does the uterus rise above its protected area within the pelvis (which trimester)
2
How sensitive is the placenta to catecholamines? What is the significance of this?
Very–thus the mother may appear relatively normal, but the fetus is suffering
When is the physiologic heart rate increase the greatest in pregnancy?
Last trimester
What happens to BP in pregnancy?
Falls
What may happen on the EKG during pregnancy?
Leftward axis shift of 15 degrees
Flattened T waves in III and avF
What is the normal amount of CO2 in pregnancy? What level may indicate an impending respiratory failure?
30 mmHg is normal due to increased tidal volume
Thus, a PaCO2 of 35-40 may indicate impending respiratory failure during pregnancy
How common is glycosuria in pregnancy?
Common
Why is gastric decompression more important in the pregnant trauma patient?
Delayed gastric emptying
What happens to the symphysis pubis in pregnancy?
Widens by 4-8 mm
What is the preferred means to increase the BP of a pregnant mother? Why?
Fluids and NOT vasopressors, because will reduce volume delivered to the fetus
What is the role of fibrinogen in late pregnancy?
Normally elevated in late pregnancy. Thus is normal or low, suspect DIC
What are the s/sx of abruptio placenta? (3)
- vaginal bleeding
- Uterine pain
- Contractions or tetany
Why are peritoneal signs more difficult to assess in the pregnant patient?
Attenuation of the abdominal wall musculature
When can fetal heart tones be heard through doppler, and when (in gestation) should continuous fetal monitoring be performed for the trauma pt?
10 weeks able to hear
beyond 20-24 weeks
