Maternity Emergencies - Basic Care and Destination Hospitals Flashcards
At what gestation should a pregnant patient be placed in a lateral tilt? How is this done and why?
> 20 weeks.
Place pt in a 30 degree tilt if supine using blankets/pilots under pt right hip to reduce aorta-caval compression and subsequent hypotension.
If a pregnant patient requires spinal immobilisation, how should this be done?
Package pt and tilt 15 degree as an entire unit.
What modification to the Oxygen guideline is made for maternity patients?
Should receive supplemental O2 if <94%, aiming for ≥94%.
How much blood can a pregnant pt lose before showing signs of shock/hypotension?
Can lose up to 30-35 % of blood volume, approx. 2L before displaying signs of shock due to high compensatory ability in pregnancy.
What is the priority in assessment and resuscitation of maternity patients?
Prioritise care of mother, as welfare of the foetus is optimised by condition of mother.
What is the risk with seemingly minor blunt trauma to pregnant patients?
Carries significant risk of foetal mortality and feto-maternal haemorrhage.
Even in minor trauma, all pregnant women should be transported to hospital to be assessed for…?
Risk of placental abruption.
When transporting a woman in labour or a baby born out of hospital, is it appropriate to bypass hospitals without a maternity service?
Yes.
When should the labouring maternity patient be transported to the hospital the patient is booked into?
If uncomplicated labour and >36 weeks gestation.
When should PIPER be consulted regarding destination hospitals?
If pre-term between 32 and 36 weeks.
Where should labouring maternity patients or newborns be transported to if <32 weeks gestation?
Closest receiving hospital with an appropriate NICU.
RWH, Mercy for Women, Monash Clayton.
If rural and any complication with labour/pregnancy, where should the pt be transported to?
Closest base hospital.
If a birth is imminent, where should a maternity pt be transported to?
Nearest hospital with a maternity service.
If time critical trauma sustained to a pregnant patient, or any potential trauma to the >24wks foetus, where should the pt be transported?
RMH if <45minutes.
Where should any pregnant patient with trauma injuries be transported to?
Trauma service - not appropriate to Tx to a maternity service.
