More of the Blessed Event Flashcards
Dilation labor stages
Early labor phase-onset to 3 cm
Active labor phase-3cm-7cm
Transition phase-7cm to 10cm (full dilation)
The baby is considered engaged when it passes the ___
spineous process
When do to an APGAR assessment?
1 minute post partum, 5 minutes post partum and evey 5 minutes until above 7
Begin ventilations when?
Begin CPR when?
HR<100
HR<60
When to do an OB entry notification
Cord prolapse
Breech presentation
Shoulder dystocia
Significant vaginal bleed in 2nd or 3rd trimester
Unexpected or impending pre-hospital birth
Information to include in the OB entry notification
Include critical issue first Age of mother Gestional age exact or estimated Mother's vital signs Current interventions
Supine hypotension syndrome
Compression of the IVC by the fetus which results in decreased venous return->decreased preload-> decreased CO
Treatment Supine hypotension syndrome
30 degree tilt to the left side. Gravity will displace the fetus
Gestational diabetes
Placental hormones impaire maternal insulin
Risk factors gestational diabetes
Maternal age >2, overweight
Gestational diabetes maternal and infant complications
Hypertension, pre-eclampsia, type 2 diabetes
Large birth weight, preterm birth with respiratory distress, hypoglycemia, type 2 diabetes and obesity, fetal/infant mortality
Placenta abruptio
Premmature separation of the placenta
Predispositions for placenta abruptio
Trauma, hypertension, pregnancy induced hypertension, multipara, cocaine, smoking, diabetes
Placenta previa
Total, partial or marginal encroachment of the cervix
Predispositions for placenta previa
Multipara, c section
Uterine rupture versus placenta abruptio
Uterine rupture will have a protruding fetal part
Predispositions for uterine rupture
Prior c-section, disproportionately large fetus
Pregnany induced hypertension signs-pre-eclampsia
Hypertension, edma, proteinuria
Cord presents first
Prolapsed cord
Treatment prolapsed cord
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
What do do when nuchal cord wrapped around the infant’s head
Attempt to slip over head
Clamp and cut
Infants butt presents first
Breech presentation
What to do for a breech presentation?
Attempt to deliver
Maintain infant’s airway-insert hand and create space between baby’s face and vaginal wall. Cord may be compressed
What do to for a limb presentation?
Pant
Knees to chest position, elevate pelvis
Rapid transprt
What constitutes a premature birth?
<38 weeks or 5 lbs
PROM
Pre-mature rupture of membranes
Post term pregnancy
> 42 weeks
Placental degradation
Turtle’s sign
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
What is the leading cause of fetal demise?
Maternal demise
What is the second leading cause of fetal demise?
Maternal shock
Mother compensates at the fetus’s expense
After considering the general impression of a pediatric patient, when should you provide immediate on scene treatment to improve patient outcome?
Cardiac arrest Complete airway obstruction Decompensated shock Impending newborn delivery Status epilepticus (establish airway) Wheezing Stridor
After considering the general impression of a pediatric patient, when should you provide immediate transport and treatment en route?
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)
