Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Domain 3 : Obstetrics > The Pregnant Trauma Patient > Flashcards

The Pregnant Trauma Patient Flashcards

1
Q

Epidemiology SOGC 2015

A

1:12 affected

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Results of PMB study

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Primary Survey: Airway management

A 
^ incidence of difficulty 
Increase mallampati score 
Mucosa oedema 
Reduced frc
Reduced compliance 
Increase resistance 
Aspiration risk
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Primary Survey Airway management

A

Small sized ETT
RSI with cricoid pressure
NGT if unconscious

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Primary Survey : Breathing

A

Increase O2 consumption

Reduced frc

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Primary Survey: breathing management

A

Supplemental O2: nasal cannula or mask or ETT

ICD placement 2 intercontinental spaces higher than usual ( upward displacement other diaphragm)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Primary Survey: circulatory concerns

A 
Increased CO
lower SVR 
Higher circulation volume
Aortocaval compression 
Placental circulation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Primary Survey : circulation management

A

X2 large bore IVC 14/16g
Vasopressors reduce placenta circulation
Bicarbonate reduces compensatory hyperventilation use with caution ⚠️
Left lateral tilt or manual displacement if cpr
Rh neg blood in emergency t/f

No inflation of abdominal part of MAST

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Primary Survey: GIT concerns

A

Reduce gastric emptying
NGT if semi/unconscious
Aspirations prophylaxis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Primary Survey: Haematology

A

Dilution anaemia
Hypercoagulable
Rh status prior to blood T/f orgive rh neg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

SOGC 1st guideline

A

Every female of reproductive age with significant injuries
should be considered pregnant until proven otherwise by a
definitive pregnancy test or ultrasound scan. (III-C

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

SOGC 2nd guideline

A

A nasogastric tube should be inserted in a semiconscious or
unconscious injured pregnant woman to prevent aspiration of
acidic gastric content. (III-C)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

SOGC 3rd guideline

A

Oxygen supplementation should be given to maintain maternal
oxygen saturation > 95% to ensure adequate fetal oxygenation.
(II-1B)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

SOGC 4th guideline

A

If needed, a thoracostomy tube should be inserted in an injured
pregnant woman 1 or 2 intercostal spaces higher than usual.
(III-C)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

SOGC 2nd guideline

A

Two large bore (14 to 16 gauge) intravenous lines should be

placed in a seriously injured pregnant woman. (III-C)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q
A

Because of their adverse effect on uteroplacental
perfusion, vasopressors in pregnant women
should be used only for intractable hypotension
that is unresponsive to fluid resuscitation. (II-3B)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q
A

After mid-pregnancy, the gravid uterus should be
moved off the inferior vena cava to increase
venous return and cardiac output in the acutely
injured pregnant woman. This may be achieved
by manual displacement of the uterus or left
lateral tilt. Care should be taken to secure the
spinal cord when using left lateral tilt. (II-1B)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q
A

To avoid rhesus D (Rh) alloimmunization in Rh-
negative mothers, O-negative blood should be
transfused when needed until cross-matched blood
becomes available. (I-A)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q
A

The abdominal portion of military anti-shock
trousers should not be inflated on a pregnant woman
because this may reduce placental perfusion. (II-3B)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q
A

In addition to the routine blood tests, a pregnant
trauma patient should have a coagulation panel
including fibrinogen. (III-C)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Transfer to healthcare facilities

A

Transfer or transport to a maternity facility (triage of a
labour and delivery unit) is advocated when injuries are
neither life- nor limb-threatening and the fetus is viable (≥
23 weeks), and to the emergency room when the fetus is
under 23 weeks’ gestational age or considered to be non-
viable. When the injury is major, the patient should be
transferred or transported to the trauma unit or
emergency room, regardless of gestational age. (III-B)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q
A

When the severity of injury is undetermined or when the
gestational age is uncertain, the patient should be
evaluated in the trauma unit or emergency room to rule
out major injuries. (III-C)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Buchsbaum criteria

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Comorbidities in pregnancy

A 
Hypertension 
Preeclampsia 
Eclampsia 
gestational diabetes 
HELLP

Amniotic fluid embolism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Imaging

A

Radiographic studies indicated for maternal evaluation
including abdominal computed tomography should not
be deferred or delayed due to concerns regarding fetal
exposure to radiation. (II-2B)

26
Q
A

Use of gadolinium-based contrast agents can be
considered when maternal benefit outweighs potential
fetal risks. (III-C)

27
Q
A

Focused abdominal sonography for trauma should be
considered for detection of intraperitoneal bleeding in
pregnant trauma patients. (II-3B)

28
Q
A

Abdominal computed tomography may be considered as
an alternative to diagnostic peritoneal lavage or open
lavage when intra-abdominal bleeding is suspected. (III- C)

29
Q

Secondary survey: history

A

Mechanism of injury
Pat obstetric hemorrhage
Course of current pregnancy
Complications from trauma: pv bleeding, abdo pain, cramps, nature of contraction, foetal movement

30
Q

Physical exam concerns

A

Shock is a late sign
Foetal distress may indicate maternal hypervolaemia
Maternal desaturation may impair fetal oxygenation

31
Q

Physica exam uterus

A
32
Q

Physical exam vaginal exam

A
33
Q
A

In cases of major trauma, the assessment, stabilization, and care of the pregnant women is the first priority; then, if the fetus is viable (≥ 23 weeks), fetal heart rate auscultation and fetal monitoring can be initiated and an obstetrical consultation obtained as soon as feasible. (II-3B)

34
Q
A

In pregnant women with a viable fetus (≥ 23 weeks) and suspected uterine contractions, placental abruption, or traumatic uterine rupture, urgent

35
Q
A

abruption, or traumatic uterine rupture, urgent obstetrical consultation is recommended. (II-3B)

36
Q
A

abruption, or traumatic uterine rupture, urgent obstetrical consultation is recommended. (II-3B)

37
Q
A

In cases of vaginal bleeding at or after 23 weeks, speculum or digital vaginal examination should be deferred until placenta previa is excluded by a prior or current ultrasound scan. (III-C)

38
Q
A

All pregnant trauma patients with a viable pregnancy (≥ 23 weeks) should undergo electronicfetal monitoring for at least 4 hours. (II-3B)

39
Q
A

Pregnant trauma patients (≥ 23 weeks) with adverse factors including uterine tenderness, significant abdominal pain, vaginal bleeding, sustained contractions (> 1/10 min), rupture of the membranes, atypical or abnormal fetal heart rate pattern, high risk mechanism of injury, or serum f ibrinogen < 200 mg/dL should be admitted for observation for 24 hours. (III-B)

40
Q
A

Anti-D immunoglobulin should be given to all rhesus D-negative pregnant trauma patients. (III-B)

41
Q
A

In Rh-negative pregnant trauma patients, quantification of maternal–fetal hemorrhage by tests such as Kleihauer-Betke should be done to determine the need for additional doses of anti-D immunoglobulin. (III-B)

42
Q
A

An urgent obstetrical ultrasound scan should be undertaken when the gestational age is undetermined and need for delivery is anticipated. (III-C)

43
Q
A

All pregnant trauma patients with a viable pregnancy who are admitted for fetal monitoring for greater than 4 hours should have an obstetrical ultrasound prior to discharge from hospital. (III-C)

44
Q
A

It is important to have careful documentation of fetal well-being in cases involving violence, especially for legal purposes. (III-C)

45
Q

Placenta abruption

A
46
Q
A

. Management of suspected placental abruption should not be delayed pending confirmation by ultrasonography; ultrasound is not a sensitive tool for its diagnosis. (II-3B)

47
Q

Uterine rupture

A
48
Q

Preterm labour

A
49
Q

Direct foetal injury

A
50
Q

Penetrating trauma

A
51
Q

Domestic violence

A
52
Q

MVA

A
53
Q

Falls

A
54
Q

Electrical trauma

A
55
Q
A

Tetanus vaccination is safe in pregnancy and should be given when indicated. (II-3B)

56
Q
A

Every woman who sustains trauma should be questioned specifically about domestic or intimate partner violence. (II-3B)

57
Q
A

During prenatal visits, the caregiver should emphasize the importance of wearing seatbelts properly at all times. (II-2B)

58
Q

Perimeter c/s

A
59
Q
A

At this time, there is insufficient evidence to support the practice of disabling air bags for pregnant women. (III)

60
Q
A
  1. A Caesarean section is recommended for viable pregnancies (≥ 23 weeks) no later than 4 minutes (when possible) following maternal cardiac arrest to aid with maternal resuscitation and fetal salvage. (III-B)

Domain 3 : Obstetrics (30 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions