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Emergecy Childbirth > Childbirth Procedures > Flashcards

Childbirth Procedures Flashcards

1
Q

In emergency childbirth what are the first two things that need to be addressed

A
  1. Assess scene safety. 2. Takes BSI precautions
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2
Q

After the scene safety and BSI, what is the next assessment that needs to be done?

A

Assess Mothers History

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3
Q

When assessing the mothers history, what 11 things need to be asked?

A
  1. Last Lmp 2. Does She Have Prenatal Care 3. Gravida /Para. 4.Any Rupture of membranes. 5.Is there any Vaginal discharge 6. Problems with pregnancy. 7. Are there Multiple births expected. 8. Types of previous deliveries. 9. Problems with past deliveries. 10. Diabetes.
  2. Drug use
    (prescription, over the counter, recreational)
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4
Q

After assessing the mothers history what comes next?

A

Assess The Contractions. 1. Frequency. 2. Duration. 3. Intensity

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5
Q

What you do after you assess contractions?

A

Determine if the delivery is imminent.

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6
Q

To determine if the delivery is imminent what do you need to check for?

A
  1. Crowning. 2. Contractions between two and three minutes apart.
  2. Urge to push.
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7
Q

After determining if the delivery is a imminent you need to determine the need for what?

A
  1. Additional resources. 2. Specialized Equipment. 3. Consider administering oxygen to the mother and or baby
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8
Q

After determining the need for additional resources and specialized equipment what you need to put on?

A

Any additional protective equipment. 1. Gown, long sleeves. 2. Face mask. 3. Eye protection. 4. Non sterile gloves

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9
Q

After putting on the additional protective equipment you want to position the mother how?

A
  1. Place the mother in a semi Fowler’s position.
  2. Elevate the mothers buttocks with pillow or blanket 2 to 4 inches. 3. Remove clothing that obstructs the perineum.
  3. Pull-up knees and spread apart.
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10
Q

After positioning the mother what do you want to do next?

A

Open The OB kit.

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11
Q

After you open it OB Kit what you want to do next

A

Cleanse the perineum with cleansing towelettes and germicidal wipes.

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12
Q

After cleansing the perineum you want to do what next?

A

Put on sterile gloves.

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13
Q

After the sterile gloves have been put on what you do next?

A

Drape mother and established a sterile field around vaginal opening.

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14
Q

For delivery of the baby what you want to make sure you do?

A
  1. Support the baby’s head and apply gentle pressure to perineum to prevent explosive delivery.
  2. Keep one hand on babies head be careful not to poke fingers in the babies eyes or Fontinalis. 3. Apply pressure to perineum with sterile towel.
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15
Q

While supporting the babies head what do you want to do next?

A

Rupture the amniotic membrane and pull membranes from baby’s mouth and nose.
To rupture membranes pinch membranes between fingers and twists until membranes tear.
2. Note color and odor of amniotic fluid. Amniotic fluid that is greenish or brownish yellow indicates fetal distress.

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16
Q

After the amniotic sac has been ruptured and the babies head has been delivered what you want to check for?

A

Check to make sure that the Umbilical cord is not around the neck.

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17
Q

If the umbilical cord is not around the neck what do you do?

A

Continue with delivery.

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18
Q

If the umbilical cord is wrapped around the neck what do you do?

A

Place two fingers under the cord at the back of the baby’s neck and gently bring forward over the head.
When the cord cannot be loosened clamp the cord in two places about 2 inches apart and carefully cut between the clamps. Unwrap the cord from the neck and continue with the delivery.

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19
Q

After cutting the cord what do you need to assist with in delivering the baby?

A

You need to assist in releasing shoulders. Upper shoulder guide head downward (if indicated). Lower shoulder guide head upward (if indicated).

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20
Q

After delivering the shoulders what comes next?

A

Assist in delivering the rest of the body.

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21
Q

After the baby has been delivered you want to hold the baby securely how?

A

Placed the baby in a Trendelenburg position. This position allows for fluids and mucus to drain from the mouth and nose. Support the head of the baby at the level of the mothers perineum.

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22
Q

Keep the baby at the level of the perineum until the cord is cut the right critical exchange of blood flow, if the baby is above the perineum what happens?

A

If the baby is kept above the perineum it siphons the blood from the baby, back into the placenta resulting in the baby becoming hypovolemic.

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23
Q

After the baby has been placed in then Trendelenburg position and the head has been supported next to the mothers perineum, you want to do what?

A

Wipe mouth and nose, suction only if there is an obvious obstruction. Routine suctioning is no longer recommended you and if there is evidence of meconium.

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24
Q

After the baby’s mouth and nose have been wiped what needs to be done next?

A

Stimulate the baby to breath. Vigorously rub the back with a towel, flick the soles of the feet. In a normal birth, the baby must be breathing on its own before clamps are applied and the cord is cut.

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25
Q

If there is no response to being stimulated after 30 seconds of stimulation what needs to be done?

A

Ventilate baby with a bag valve mask. Initial resuscitation should begin with room air. If the heart rate is less than 60 bpm after 90 seconds of Resuscitation with Room air, increase oxygen to 100% 15 L by mask until heart rate is greater than 120.

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26
Q

After stimulating the baby what needs to be done next?

A

The cord needs to be clamped. Cord clamping should be delayed at least one minute for term babies that are breathing. For resuscitation, the cord may need to be clamped and cut earlier. The cord need not finish pulsating before it is clamped and cut.

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27
Q

How do you clamp the umbilical cord?

A

Double clamp the umbilical cord, first clamp 6 to 8 inches from baby, second clamp 2 to 3 inches from the first clamp toward the mother.

28
Q

Next cut the cord!

Where do you cut the umbilical cord?

A

Cut the umbilical cord between the clamps.

29
Q

After the umbilical cord has been cut what needs to be done next for the baby?

A

Dry and wrap the baby in a blanket or Towel. Newborns become hypothermic very rapidly, wrap the baby so only the face is exposed. They lose most of their heat from the head area.

30
Q

Once the baby is wrapped in a blanket, direct your assistant to monitor and complete initial care of the baby what does that entail?

A

Place the baby on its side with head slightly lower than the trunk or give the baby to the mother to hold against her chest and breast feed.

31
Q

After the baby has been taken care of you want to assess the mothers vital signs and check for what?

A

Vaginal bleeding. Blood loss of greater than 500 cc is considered maternal hemorrhage this is a medical emergency.

32
Q

After the mother has been checked for vaginal bleeding and her vital signs you want to observe for what?

A

Observe for signs of placenta separation, lengthening of the umbilical cord, contraction of the uterus, and gush of blood from the vagina.

33
Q

To prepare for delivery of the placenta what must you have a mother do?

A
  1. Have a mother bear down.
  2. Have Bason ready to receive placenta.
  3. Expect a gush of blood after placenta is delivered.
34
Q

Next to deliver the placenta you must. …

A
  1. Grasp the placenta when it appears at the vaginal opening.
  2. Rotate the placenta, do not pull on the cord. 3. Guide the placenta and membranes from the vaginal opening into a basin or towel.
  3. Check for integrity of the placenta and cord.
35
Q

After the delivery of the placenta check for what next

A

Check for perineal lacerations and apply pressure to control bleeding, if there is a perineal tear, inform mother that this is normal and will be taken care of by a doctor at the hospital.

36
Q

After informing the mother of the perineal lacerations remove what?

A

Remove the soiled sheets and place in a plastic bag.

37
Q

To control the bleeding of the vaginal area what should be placed over the perineal area?

A

Please 0B pads over the perineal area. Touch only the outer surface of the Pads.
Place pads from vagina down towards anus.
Assist mother in putting thighs together to hold pads in place.

38
Q

Next what should you assess every five minutes and massage it indicated

A

You want to assess the fundus every five minutes and massage if indicated. Place one hand above the pubic bone. Place the other hand above the contracted uterus. Massage over area using a circular motion until the uterus is firm. Fundal massage is performed only after the placenta has been delivered.

39
Q

Next provide what for the mother?

A

Provide comfort and support and transport, the mother will chill easily after giving birth due to decreasing blood boil. Cover her with a blanket to keep her warm.
The mother and newborn should be transported to the same facility.
BLS units shall call for an ALS unit or transport to the most appropriate hospital.

40
Q

Ongoing assessment

How often should you repeat an ongoing assessment?

What needs to be assessed in the ongoing assessment?

A

Ongoing assessment needs to be every five minutes.

Primary assessment.
Relevant portion of the secondary assessment, and vital signs.

41
Q

How do you evaluate response to treatment and when?

A

Patients must be re evaluated at least every five minutes or sooner if any treatment was initiated, medication administered or a change in the patient’s condition occurs or is anticipated.

42
Q

In evaluating the results of the reassessment you want to do what if the patients previous condition and vital signs change?

A

You want to compare results,assistant in recognizing if the patient is improving,responding to treatment or condition is deteriorating.

43
Q

For the patient report and documentation you want to verbalize and document what?

A

Two EMS forms are necessary, one for the mother and one for the baby (two patients).
Time of delivery of baby and placenta.
1. Time of delivery for the baby is the time when the babies body is delivered.
2. The time of delivery for the placenta is when it passes out of the vagina.

44
Q

For patient report and documentation you also want to document?

A 
LMP. 
Problems with the pregnancy. 
Vaginal discharge. 
Number pregnancies and births. 
Types of previous deliveries. 
Estimated blood loss. 
Integrity of the placenta and cord. 
Condition of the baby. 
And fundal massage.
45
Q

What are the three stages of labor?

A
  1. 1st. stage (dilation stage).
    Starts with regular contractions and thinning and gradual dilation of the cervix. Ends with complete dilation of the cervix.
  2. 2nd stage (Expulsion stage)
    Starts with baby entering the birth canal. Ends with the delivery of the baby.
  3. 3rd stage (Placental stage)
    Starts with the delivery of the baby. Ends with the delivery of the placenta.
46
Q

In evaluation of the newborn what is the first thing you need to do?

A

Take BSI isolation Precautions.

Determine additional resources or any specialized equipment.

47
Q

In evaluating the newborn and after taking BSI precautions what Needs to be done next?

A

You want to assess and support body temperature by drying the newborn completely and wrapping the newborn head to toe, with head covered.

48
Q

After supporting the body temperature of the newborn what Needs to be done next?

A

ABC’s
Assess and support the newborns Airway. Position newborn on back or side with the neck in a neutral position. Suction with bulb syringe only if airway is obstructed.

49
Q

After assessing the newborns Airway what comes next?

A

Assessing the newborns breathing.

And intervene if necessary.

50
Q

In assessing the newborns breathing if the respirations are adequate it would be between how many breaths per minute?

A

40 to 60

51
Q

When assessing the newborns breathing and it is Shallow or slow what needs to be done?

A

Administer 02 room air via bvm And stimulates for 30 seconds.
Stimulate by vigorously rubbing back with a towel or flicking the soles of the feet.

52
Q

When assessing the newborns breathing if the baby is Gasping for air or in adequate title volume, What needs to be done?

A

Ventilate with BVM at 40 to 60 breaths per minute with room air, if There is no increase in heart rate ventilate with hundred percent O2.

53
Q

After assessing the breathing of a newborn what Needs to be assessed next?

A

Circulation, and intervene as necessary.

54
Q

When assessing circulation if the heart rate is greater than 120 bpm what needs to be done?

A

Continue assessment.

55
Q

When assessing circulation if the heart rate is 100 - 120 bpm what needs to be done?

A

Administer room air O2 via bvm for (30 seconds).

56
Q

When assessing circulation and the newborns heart rate is less than hundred beats per minute what needs to be done?

A

Positive pressure ventilation with BVM at 100% O2.

57
Q

When assessing the circulation of a newborn and a heartbeat is less than 60 bpm after positive pressure ventilation for 30 seconds what needs to be done?

A

Administer 100% O2 via BVm and start CPR.

58
Q

When assessing the newborns circulation and color, if the baby is pink with peripheral cyanosis of hands and feet what are the indications?

A

No treatment indicated.

59
Q

When assessing the newborns circulation and color, if central cyanosis is apparent good respirations and heart rate less than 100 beats per minute what needs to be done?

A

Administer room air O2 via BVM for 30 seconds.

60
Q

When assessing the newborn circulation and color and generalize pallor or cyanosis with no response what needs to be done?

A

Ventilate with 100% O2 with BVM mask.

61
Q

What needs to be done when assessing the umbilical cord what are you checking for?

A

If there’s any bleeding. If so apply sterile dressing and hold direct Pressure.

And the security of the clamps or ties,if needed apply additional clamps or ties.

62
Q

When reassessing the newborn you want to perform a pulse check how often?

A

Every 30 seconds.

63
Q

How often should the baby be assessed for breathing circulation and warmth?

A

Baby needs to be assessed every 60 seconds for breathing circulation and warmth, primary assessment and vital signs.

64
Q

How often should do newborn be assessed if he or she has abnormal vital signs or signs and symptoms of poor perfusion, Or if there is any suspicion that the patient’s condition may deteriorate?

A

Every 30 seconds.

65
Q

How often should a baby or newborn be reevaluated if any treatment was initiated medication administered or change in the patient’s condition occurs or is anticipated?

A

Every 30 to 60 seconds.

66
Q

When evaluating the results of the reassessment you want to note what?

A

Any changes from the previous condition and vital signs, when I compare the results and assist in recognizing the baby is improving,responding to treatment or condition is deteriorating.

67
Q

What do you want to verbalize,report,and document for the newborn?

A
  1. Time of delivery of the baby.
  2. The sex.
  3. Problems with the pregnancy.
  4. Was there any presence of meconium
  5. Integrity of the cord.
  6. Condition of the baby.
  7. Initial and ongoing assessment.
  8. Treatment rendered.
  9. Response to

Emergecy Childbirth (1 decks)

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