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OB EMS Emergencies PowerPoint Presentation

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Description : Check out this medical presentation on Emergency Medical Services (EMS), which is titled "OB EMS Emergencies", to know about Obstetric emergencies.

Tags : Emergency Medical Services, EMS, OB, EMS Emergencies, Obstetric emergencies

Published on : Aug 06, 2021 | Views : 3563 | Downloads : 13

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Slide 1-

OB EMS Emergencies Presented by Jodi McGraw, M.D.
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History Gravida (gravidity)= number of pregnancies Para (parity)= number viable gestational age pregnancies Eg. G3P2 (third pregnancy & 2 deliveries) G5P2 (1,1,3,2)=full term, preterm, miscarriage or abortions, living Trauma in OB, treat the Mom O2, 2x large bore IV’s, left lateral Position if able based on trauma. Treat the injuries
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Documentation Medical documentation obtained at Patient visits for patient record
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Documentation Symptoms since LMP, genetic screening Infection history, physical exam
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Documentation Additional notes for visit
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Documentation Typical format for OB visit details
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Documentation Labs & education at visits
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Documentation Labs for 2nd & 3rd trimesters
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Documentation Plans & education
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ER Physician Brief 19 yo G1P0 at 39 EGA, no local medical care, uncomplicated pregnancy, negative GBS at 36 weeks, no meds, NKDA, healthy Contractions q3 min Fluid leaking (?clear), but not bleeding +fetal movement A few potential problems: Edema 60# weight gain Elevated blood pressure, leg swelling, Bleeding, abdominal pain, SOB
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EMS OB Delivery Kit Remember PPE Use a towel to dry/swaddle baby, if needed
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OB Instruments This is what our OB tray looks like Basic EMS kit will have essentials
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Documentation Record and document events as able Most important times: infant birth time placenta delivery time
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PreEclampsia Elevated blood pressure and Proteinuria (edema not required) Worst complication is seizure/HELLP (hemolysis, elevated LFT’s, low platelets) In pregnancy, eclampsia seizures treated with Mg IV Benzodiazepines do not stop seizures in eclampsia IV x 2, O2, can check reflexes
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Prolapsed Cord Cord dangling out of vagina or cervix Compresses baby’s lifeline EMERGENCY! Notify ER! Elevate pelvis and manually Push infants head off the cord Without compressing the cord Emergent Cesarean! IV x 2, O2
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Abruptio Placentae Typically severe abdominal pain (not just with contractions) Bleeding extent may not be apparent EMERGENCY! Start O2, IV x 2, position
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Normal Delivery Pushing can be >2 hours in primiparous Patient, but may be 1-2 hours in multiparous May be precipitous If preterm, expect precipitous & consider Malpresentations- eg breech Chin first does not deliver! Neck can not hyperextend Clamp x 2 & cut cord between clamps Placenta may take ~1-20 minutes
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Breech Delivery 3-4% of deliveries, injuries e.g. clavicle fractures more common Prematurity is risk Deliver spontaneous until umbilicus is at introitus Then, support trunk Remove 1 arm at a time Head most difficult: Flex neck
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shoulder Dystocia H call for Help! E Evaluate for Episiotomy L Legs – McRoberts maneuver P supraPubic Pressure E Enter, rotational maneuvers R Remove the posterior R Roll the patient to her hands & knees
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Hemorrhage 2nd & 3rd trimester bleeding: placenta previa uterine rupture placenta abruption vasa Previa Postpartum hemorrhage- compress O2, IV x 2, compression, position
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Demo with Mannequin: Noelle Awesome! Please feel welcome to participate and ask questions
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Summary Good history Evaluate for complications Bleeding/hemorrhage DVT Pre-eclampsia delivery
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Thank You With Great Appreciation for all you do! Questions? Practice with mannequin?