Obstetrics

Question 1

What are key trigger points for antepartum haemorrhage?

Answer 1

Is bleeding > 20 weeks? = tpt

Is pt hypovolaemic or poorly perfused? = request paramedic IV support

Question 2

What are key treatment triggers for postpartum haemorrhage?

Answer 2

Is post birth bleeding >500ml? = tpt

Question 3

How can an EMT help manage postpartum haemorrhage?

Answer 3

pressure on compressible bleeding
help from LMC
nipple stimulation (or request paramedic for oxytocin + IV /adrenaline therapy)
Consider bimanual compression

Question 4

Under what conditions does a miscarriage not need immediate referral/transport?

Answer 4

if 1st trime and pain is not severe, consistent with menstrual pain, bleeding is not significant

Question 5

What are the key principles of delivery for EMT?

Answer 5

pull to side of road
pt in preferred position
support babys head and shoulders
dry baby
Skin to skin if neither requires rescusc
Observe breathing and activity
Clamp and cut cord 5cm from the baby w/in 5 minutes of birth
Allow placenta to deliver spontaneously (save in plastic bag)
Following placental delivery rub uterus until it feels firm
Suggest no pushing in case of prolapsed umbillicus or breech delivery
Tpt in cases of retained placenta/prepare for pph