Emergency Childbirth Medical Directive Flashcards
Emergency Childbirth MD
What are the indications for the emergency childbirth MD?
Pregnant patient experiencing labour; OR
Post-partum patient immediately following delivery and/or placenta.
Emergency Childbirth MD
What are the conditions for delivery?
Age: Child-bearing years
Other: Second stage labour
AND/OR
Imminent birth
AND/OR
Shoulder dystocia
AND/OR
Breech delivery
AND/OR
Prolapsed cord
Emergency Childbirth MD
What are the conditions for umbilical cord management?
Age: Childbearing years
Other: Cord complications
OR
If neonatal or maternal resuscitation is required
OR
Due to transport considerations
Emergency Childbirth MD
What are the conditions for external uterine massage?
Age: Childbearing years
Other: Post-placental delivery
Emergency Childbirth MD
What are the conditions for oxytocin administration?
Age: Childbearing years
SBP: <160 mmHg
Other: Postpartum delivery
AND/OR
Placental delivery
Emergency Childbirth MD
What are the contraindications to delivery?
N/A
Emergency Childbirth MD
What are the contraindications to umbilical cord management?
N/A
Emergency Childbirth MD
What are the contraindications to external uterine massage?
Placenta not delivered
Emergency Childbirth MD
What are the contraindications to oxytocin administration?
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
Emergency Childbirth MD
For shoulder dystocia deliveries, how many times should ALARM be performed?
Two times. If successful, deliver neonate. If unsuccessful; transport to closest appropriate facility.
Emergency Childbirth MD
How long since umbilicus was visualized should we attempt the Mauriceau Smellie-Veit maneuver in breech deliveries?
Once the hairline is visible AND/OR 3 minutes have passed.
Emergency Childbirth MD
What should you do if there is a cord prolapse?
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.
Emergency Childbirth MD
What is the dosing for oxytocin?
Route: IM
Dose: 10 units
Max 1 dose