More of the Blessed Event

Question 1

Dilation labor stages

Answer 1

Early labor phase-onset to 3 cm
Active labor phase-3cm-7cm
Transition phase-7cm to 10cm (full dilation)

Question 2

The baby is considered engaged when it passes the ___

Answer 2

spineous process

Question 3

When do to an APGAR assessment?

Answer 3

1 minute post partum, 5 minutes post partum and evey 5 minutes until above 7

Question 4

Begin ventilations when?

Begin CPR when?

Answer 4

HR<100

HR<60

Question 5

When to do an OB entry notification

Answer 5

Cord prolapse
Breech presentation
Shoulder dystocia
Significant vaginal bleed in 2nd or 3rd trimester
Unexpected or impending pre-hospital birth

Question 6

Information to include in the OB entry notification

Answer 6

Include critical issue first
Age of mother
Gestional age exact or estimated
Mother's vital signs
Current interventions

Question 7

Supine hypotension syndrome

Answer 7

Compression of the IVC by the fetus which results in decreased venous return->decreased preload-> decreased CO

Question 8

Treatment Supine hypotension syndrome

Answer 8

30 degree tilt to the left side. Gravity will displace the fetus

Question 9

Gestational diabetes

Answer 9

Placental hormones impaire maternal insulin

Question 10

Risk factors gestational diabetes

Answer 10

Maternal age >2, overweight

Question 11

Gestational diabetes maternal and infant complications

Answer 11

Hypertension, pre-eclampsia, type 2 diabetes
Large birth weight, preterm birth with respiratory distress, hypoglycemia, type 2 diabetes and obesity, fetal/infant mortality

Question 12

Placenta abruptio

Answer 12

Premmature separation of the placenta

Question 13

Predispositions for placenta abruptio

Answer 13

Trauma, hypertension, pregnancy induced hypertension, multipara, cocaine, smoking, diabetes

Question 14

Placenta previa

Answer 14

Total, partial or marginal encroachment of the cervix

Question 15

Predispositions for placenta previa

Answer 15

Multipara, c section

Question 16

Uterine rupture versus placenta abruptio

Answer 16

Uterine rupture will have a protruding fetal part

Question 17

Predispositions for uterine rupture

Answer 17

Prior c-section, disproportionately large fetus

Question 18

Pregnany induced hypertension signs-pre-eclampsia

Answer 18

Hypertension, edma, proteinuria

Question 19

Cord presents first

Answer 19

Prolapsed cord

Question 20

Treatment prolapsed cord

Answer 20

Pant
Knees to chest
Trendelenberg with pelvis elevated
Manual pressure to decompress the cord
Transport in this position
Want to prevent the mother from delivering

Question 21

What do do when nuchal cord wrapped around the infant’s head

Answer 21

Attempt to slip over head

Clamp and cut

Question 22

Infants butt presents first

Answer 22

Breech presentation

Question 23

What to do for a breech presentation?

Answer 23

Attempt to deliver

Maintain infant’s airway-insert hand and create space between baby’s face and vaginal wall. Cord may be compressed

Question 24

What do to for a limb presentation?

Answer 24

Pant
Knees to chest position, elevate pelvis
Rapid transprt

Question 25

What constitutes a premature birth?

Answer 25

<38 weeks or 5 lbs

Question 26

PROM

Answer 26

Pre-mature rupture of membranes

Question 27

Post term pregnancy

Answer 27

> 42 weeks

Placental degradation

Question 28

Turtle’s sign

Answer 28

Associated with post-term babies
Large birth weigh babies where shoulders >head
During a contraction the head comes out, then the head goes back in

Question 29

What is the leading cause of fetal demise?

Answer 29

Maternal demise

Question 30

What is the second leading cause of fetal demise?

Answer 30

Maternal shock

Mother compensates at the fetus’s expense

Question 31

After considering the general impression of a pediatric patient, when should you provide immediate on scene treatment to improve patient outcome?

Answer 31

Cardiac arrest
Complete airway obstruction
Decompensated shock
Impending newborn delivery
Status epilepticus (establish airway)
Wheezing
Stridor

Question 32

After considering the general impression of a pediatric patient, when should you provide immediate transport and treatment en route?

Answer 32

Incomplete airway obstruction
Compensated shock
Closed head injury with normal airway breathing
Multi system trauma
Inability to treat on scene (safety, equipment failure, procedue failure)