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EMT-B OBGYN Emergencies Chapter 24 Brady 10th Edition

cephalic presentation presenting part is head
breach presentation buttocks or both feet deliver first
second stage of labor full dilation of cervix, baby enters birth canal until born, EMT-B decides to transport or prepare to assist with delivery
third stage of labor after baby is born until the afterbirth is delivered
meconium staining amniotic fluid is greenish or brownish-yellow, may indicate maternal or fetal distress
supine hypotensive syndrome also vena cava compression syndrome; mass compressing vena cava, major blood vessel, reducing return of blood to heart, reducing cardiac output - resulting in dizziness and drop of bp
vena cava compression syndrome supine hypotensive syndrome
fontanelles soft spots on baby's skull
normal pulse for newborn greater than 100
Apgar scale evaluation protocol for newborns
APGAR Appearance, Pulse, Grimace, Activity, Respiratory effort - 0, 1, 2
APGAR Appearance 0 - blue or pale all over, 1 - extremeties blue, trunk pink, 2 - pink all over
APGAR Pulse 0 - no pulse, 1 - pulse between 1 and 100, 2 - pulse greater than 100
APGAR Grimace (reaction to suctioning or flicking on the feet) 0 - no reaction, 1 - facial grimace, 2 - sneeze, cough, cry
APGAR Activity 0 - no movement, 1 - only slight activity (flex extremities), 2 - move around normal
APGAR Respiratory effort 0 - none, 1 - slow, irregular breathing, weak cry, 2 - good breathing, strong cry
artificial ventilation rate during neonatal resuscitation 40 to 60 per minute - rapid, small puffs - reassess in 30 seconds
What if heart rate is less than 60 minute initiate chest compressions at rate of 120 per minute - 90 compressions and 30 ventilations each minute
What if baby exhibits cyanosis of face or torso supplemental oxygen at 10-15 liters per minute with tubing placed close to infant's mouth
Clamping and cutting cord keep infant warm, use sterile clamps from OB kit, slowly tie square knot, one clamp 10 inches from baby, other about 7 inches out, cut between clamps
How much blood loss is normal after delivering the baby and placenta? 500 cc
How can you control vaginal bleeding after delivery of the baby and placenta? sanitary napkin, lower legs and raise feet, massage the uterus to help it contract (circular motion), mother nurse baby which leads to contraction of uterus (not recommended by all docs)
prolapsed unbilical cord cord is pinched, most common in breech births, caused by being squeezed between vaginal wall and baby's head
How do you care for prolapsed umbilical cord? elevate hips, oxygen, keep mother warm, keep baby's head away from cord, don't push cord back in, wrap cord in moist towel. Transport, continue pressure on baby's head.
How do you care for the baby if you see meconium staining? suction the oropharynx before stimulating, suction mouth, then nose. Maintain airway, provide ventilations or compressions if needed, transport
What is placenta previa? placenta is formed in an abnormal location like low in uterus and close to or over the cervical opening, not allowing normal delivery, causes excessive prebirth bleeding - cervix dilates, the placenta tears
What is abruptio placentae? placenta separates from the uterine wall, causing prebirth bleeding, occurs in 3rd trimester
What is an ectopic pregnancy? implantation of the fertilized egg is in the ovidcut, cervix, or abdominopelvic cavity
What are signs of a ectopic pregnancy? acute abdominal pain, often beginning on one side, vaginal bleeding, rapid or week pulse, low BP
How do you care for a patient with ectopic pregnancy? immediate transport, position and care for shock, high concentration oxygen, nothing by mouth
What is eclampsia? eclampia is complication late in pregnancy that produces seizures and coma.
What is preeclampsia? complication during pregnancy where woman retains large amounts of fluid and has hypertension. She may also experience seizures or coma. very dangerous to baby.
What are signs of seizure from preeclampsia? elevated BP (increased with risk of abruptio placentae), excessive weight gain, extreme swelling of face, hands, ankles, feet; headache
How do you care for patient with seizures during pregnancy? airway, high concentration oxygen, transport with patient on left side, gentle, keep her warm, not overheated though; have suction and OB kit ready
Created by: jstjohn