Emergency Childbirth Medical Directive Flashcards

1
Q

Emergency Childbirth MD

What are the indications for the emergency childbirth MD?

A

Pregnant patient experiencing labour; OR
Post-partum patient immediately following delivery and/or placenta.

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2
Q

Emergency Childbirth MD

What are the conditions for delivery?

A

Age: Child-bearing years
Other: Second stage labour
AND/OR
Imminent birth
AND/OR
Shoulder dystocia
AND/OR
Breech delivery
AND/OR
Prolapsed cord

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3
Q

Emergency Childbirth MD

What are the conditions for umbilical cord management?

A

Age: Childbearing years
Other: Cord complications
OR
If neonatal or maternal resuscitation is required
OR
Due to transport considerations

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4
Q

Emergency Childbirth MD

What are the conditions for external uterine massage?

A

Age: Childbearing years
Other: Post-placental delivery

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5
Q

Emergency Childbirth MD

What are the conditions for oxytocin administration?

A

Age: Childbearing years
SBP: <160 mmHg
Other: Postpartum delivery
AND/OR
Placental delivery

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6
Q

Emergency Childbirth MD

What are the contraindications to delivery?

A

N/A

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7
Q

Emergency Childbirth MD

What are the contraindications to umbilical cord management?

A

N/A

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8
Q

Emergency Childbirth MD

What are the contraindications to external uterine massage?

A

Placenta not delivered

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9
Q

Emergency Childbirth MD

What are the contraindications to oxytocin administration?

A

Allergy or sensitivity to oxytocin
Undelivered fetus
Suspected or known pre-eclampsia with current pregnancy
Eclampsia (seizures) with current pregnancy
≥4 hours post placenta delivery

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10
Q

Emergency Childbirth MD

For shoulder dystocia deliveries, how many times should ALARM be performed?

A

Two times. If successful, deliver neonate. If unsuccessful; transport to closest appropriate facility.

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11
Q

Emergency Childbirth MD

How long since umbilicus was visualized should we attempt the Mauriceau Smellie-Veit maneuver in breech deliveries?

A

Once the hairline is visible AND/OR 3 minutes have passed.

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12
Q

Emergency Childbirth MD

What should you do if there is a cord prolapse?

A

If a cord prolapse is present, the fetal part should be elevated to relieve pressure on the cord. Assist the patient into a knee-chest position or exaggerated Sims position, and insert gloved fingers/hand into the vagina to apply manual digital pressure to the presenting part which is maintained until transfer of care in hospital.

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13
Q

Emergency Childbirth MD

What is the dosing for oxytocin?

A

Route: IM
Dose: 10 units
Max 1 dose

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