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122 Cards in this Set
- Front
- Back
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What is the fetus
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Developing unborn Baby
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What is the Uterus
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Organ in which the fetus grows, responsible for labor and expulsion of the infant
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What is the Birth Canal
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Vagina, cervics and lower part of the Uterus
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What is the Placenta
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Fetal organ through which fetus exchanges nourishment and waste products
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What is the Umbilical Cord
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Cord which is an extension of the placenta through which the fetus receives nourishment while in the uterus
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What is the Amniotic Sac
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The sac that surrounds the fetus inside the uterus
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What is the Vagina
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lower part of the birth canal
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What is the cervix
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inferior opening to the uterus that connects the vigina to the uterus
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What is the Perineum
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Skin between the vagina and the anus, commonly torn during delivery
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What is crowning
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The bulging-out of the vagina which is opening as the fetus head or presenting part presses against it
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What is the Bloody Show
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Mucus and blood that are expelled from the vagina as labor begins
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What is the Presenting Part
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The part of the infant/fetus that comes first (usually the head)
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What is Abortion
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Miscarriage - Delivery of products of conception early in pregnancy
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What is LMP
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Last Menstrual Period
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What is Gravida
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The number of pregnancies a woman has had
Primagravdia is her first |
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What is Para
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The number of live births a women has had
Primapara is her first |
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What is considered a Live Birth
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A baby that survives 24hrs
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What is the Fundus
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The top of the Uterus
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Who should we assume could be pregnant
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Any woman 8 to 80
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Describe the Menstrual Cycle
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28 Days
Day 1-5 Uterine lining sloughs off creating the Menstrual Flow Day 6-13 Uterine lining repaired Day 14 Ovulation Day 15-28 Uterine ling grows thicker |
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What is the soft spot in the babies head called
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Fontanelle
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What needs to be done to support a babies airway
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Blanket under the shoulders to open airway
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What is a zygote
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A fertilzed egg
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What does Full Term mean
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The length of a pregnancy 40 weeks or 280 days
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What is a Trimester
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A three month period of the pregnancy
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In what Trimester will a mother begin to feel the baby move
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2nd - 16-20 Weeks
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Where is the fundus at 20 weeks
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At or below the umbilicus
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What Cardiovascular changes take place in an expectant mother
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Blood volume increases
Cardiac output and heart size increase Blood pressure decreases slightly |
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What respiratory changes take place in expectant mothers
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Blood vessels enlargement in respiratory tract
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What GI changes take place in the expectant mother
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Organ position
Metabolism is accelerated |
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What should you expect in the scene sizeup of a possible pregnant patient
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High stress
Inaccurate info Downright lying |
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Is there any change in the initial assessment
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No
ABC |
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How should you handle the Focused history and physical Exam of a potentially pregnant patient
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SAMPLE and OPQRST but ask more detailed questions
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What questions should you ask a potentially pregnant patient
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Have you ever been Pregnant before
LMP Missed any periods Unusual vaginal discharge Due date |
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How can you tell Delivery is imminent
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Parity and durations of previous labors
Contractions 2 min apart or closer and lasting 60 to 90 Seconds Bloody show and bag of water rupture Urge to push or defecate Crowning Patients abdomen is rock hard |
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What other factors should you consider for field delivery
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Natural disaster
No transport |
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What should you not do if delivery is imminent
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Don't let mom go to bathroom
Don't hold her legs together Don't touch vaginal areas except during delivery unless partner is present |
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How many OB kits do you bring
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2
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What are the 3 stages of labor
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1 - Begins with the first uterine contraction and ends with complete dilation of cervix (10cm)
2 -Begins with Cervix dilated and ends in delivery of baby 3 - Begins with delivery of baby and ends in delivery of placenta |
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T/F
Moms gonna poop and its OK |
True but don't deliver the baby into fecal matter
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Why should you apply back pressure to the babies head during delivery
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To prevent explosive delivery
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How can you protect the perineum from tearing
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Gentle pressure of massage to loosen it
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What is the term for the umbilical cord around the infants neck
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Nuchal Cord
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What should be done to the infant once its head is out
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Ask mom to stop pushing and suction the mouth then the nose
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How should we handle a Nuchal cord
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First try to slip it over the shoulder
If not then clamp cut and unwrap it from the baby |
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What should be checked after the baby's head is out
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Check for Nuchal cord
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What do you suction first the mouth or the nose
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Mouth then the nose
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What is a key thing to remember during the closing moments of the delivery
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Babies are slippery
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How can you assist the delivery of the baby's shoulders
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Lift the baby up to get the first one out then lower the baby to get the second
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Where should the baby be after delivery and before the cord is cut
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At the level of the vagina to prevent blood flow back into the placenta
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Where should the cord be clamped and cut
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4 and 6 inches from the baby and cut between the clamps after the pulsations cease
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What should be done for the baby once it is delivered
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Assigned to another EMT for care
Suction mouth and nose again Remove mucus and blood with sterile gauze Wrap baby in warm blanket |
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What comes after the baby
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The placenta
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What needs to be done with the placenta
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Wrap it in a towel
Place it in a plastic bag Bring it to the hospital |
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How much blood is normal after a delivery
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500 cc
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What can be done to slow or stop bleeding after delivery
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Allowing baby to nurse will cause contractions and slow bleeding
Fundus Massage with stimulate contractions |
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List Nine Predelivery Emergencies
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Spontaneous Abortion
Pre Eclampsia Eclampsia Supine Hypotensive Syndrome Placenta Abrubtio Placenta Previa Vaginal Bleeding Ectopic Pregnancy Trauma |
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Describe Spontaneous Abortion
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AKA Miscarriage
Delivery before the 20th week |
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What are the signs and symptoms of Spontaneous Abortion
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Cramp-Like abdominal pain
Moderate to severe vaginal bleeding Passage of tissue or clots |
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How do we treat for Spontaneous Abortion
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Get a good history
Ask about LMP Treat for shock Transport Bring any passed tissue to hospital |
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Describe Pre Eclampsia
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Pregnancy induced Hypertension
Develops after 20 weeks |
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What are the Signs and Symptoms of Pre Eclmapsia
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Headache
Seeing Spots Distal Edema Anxiety Hypertention |
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Describe Eclampsia
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Uncontrolled Pre Eclampsia will lead to Eclampsia
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What are the signs and symptoms of Eclampsia
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Convulsions
Coma |
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How do we treat for Eclampsia
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Call for ALS
Place patient in left lateral recumbent position Maintain airway Oxygen Transport |
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Describe Supine Hypotensive Syndrome
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Weight of Baby compresses the inferior vena cava lowering blood pressure
Hypotension develops when mother lays supine |
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How do we treat for Supine Hypotensive Syndrome
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Place patient in recovery position
Oxygen Treat for shock Call for ALS Transport |
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Describe Placenta Previa
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Placenta develops over the cervix
Vaginal Delivery is not an option May cause bleeding Should not be painful |
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How do we treat for Placenta Previa
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O2
Sterile pad over vagina to control bleeding Treat for shock if needed Transport |
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Describe Placenta Abrubtio
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Placenta separates from uterine wall
Extremely painful Harmful to mother and baby May bleed |
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How do we treat for Placenta Abrubtio
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Control bleeding with Sterile pad
Oxygen Treat for Shock Call for ALS Transport |
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Describe Vaginal bleeding
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Late pregnancy vaginal bleeding can be present with or without pain
Can indicate a spontaneous abortion May be an Ectopic pregnancy |
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What is a leading cause of death in pregnant women
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Ectopic pregnancy
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Describe Ectopic pregnancy
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Pregnancy develops outside of the Uterus (Usually in Fallopian tube)
Sudden Abdominal Pain |
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What are three predisposing factors for Ectopic pregnancy
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History of pelvic inflammatory disease
Tubal ligation Previous ectopic pregnancies |
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How many patients do you have with a pregnant patient
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two
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Which patient is more important
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Mom
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What should be done when backboarding a pregnant patient
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Straps above and below the belly
Raise the board to place patient leaning to the left side |
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List some Abnormal or complicated Delivery Emergencies
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Prolapsed cord
Breech presentation Limb Presentation Ruptured Uterus Head delivery problems Meconium Staining Twins Multiple births Premature births Fetal demise |
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Describe Prolapsed Cord
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The umbilical cord presents first from the birth canal
The cord gets compressed between vaginal wall and pubic bone and infant decreasing blood flow to infant |
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What factors predispose a patient to Prolapsed cord
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Premature birth
Multiple Births Premature rupture of the amniotic Sac |
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How do we position the mother for Prolapsed Cord
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Position Mom in the "Knee-Chest" or Trendelenbug Position
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How do we treat for Prolapsed Cord
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Insert Sterile-gloved hand into vagina and gently push the presenting part of fetus off of the cord ensuring cord is pulsing
Cover exposed cord with sterile moistened dressing and keep warm Do not deliver Transport in this position |
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Describe Breech Birth Presentation
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Delivery where the buttocks or lower extremities present first
The infant is at risk for delivery trauma, prolapsed cord, and inability to deliver head Deliver this baby |
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What must be done if the infants head does not deliver in 3 minutes after the rest of the body
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Place gloved fingers into the vagina in a "V" shape to establish an airway for the infant
Transport while maintaining infants airway |
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Describe Limb Birth Presentation
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Occurs when a limb of the infant protrudes from birth canal (usually a foot)
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How do we treat a patient with Limb Birth Presentaion
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Cover Limb in Sterile Dressing
Do Not push it back in Do not pull it out Transport Mother in Knee Chest position Head down and pelvis up |
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Describe Ruptured Uterus
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Occurs when a weakening in the Uterine wall ruptures releasing the fetus into the abdominal cavity
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What predisposes a patient for a Ruptured Uterus
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History of Uterine rupture
Abdominal trauma Large Fetus Multipara Prolonged and difficult labor History or Caesarean section or uterine surgery |
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What are the signs and Symptoms of a ruptured Uterus
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Tearing sensation in the abdomen
Constant and severe abdominal pain Nausea Hypoperfusion Vaginal Bleeding Cessation of contractions Able to palpate fetus in abdominal cavity |
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How do we treat a patient for Ruptured Uterus
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Treat for Shock
Oxygen Transport |
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List two Complications that may occur with normal head delivery
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Unruptured Amniotic Sac
Nuchal Cord |
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How do we treat a patient when the Amniotic Sac has not broken and the infant is presenting
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Punture the sac and push it away from the baby
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What is the offical term for False Labor
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Braxton Hicks Contractions
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What is a Precipitous Delivery
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Birth of the infant occurs less than 3 hours after the start of labor
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What is the term used to describe the condition of the babies shoulders being larger than the head
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Shoulder Dystocia or Turtle effect
Transport Immediately |
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Describe Meconium Staining
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The baby because of delivery stress pooped in the Amniotic Sac causing it to turn green or brown
Bad for infant to breath Amniotic fliud mixed with poo |
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How do we treat the infant if Meconium staining is present
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Do not stimulate the infant prior to Suctioning the oropharynx
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What should you suspect if the mothers Abdomen remains large after delivery
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Another baby Twins!
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Why do you need to call for additional resources if Mom is having twins
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Every patient needs its own EMT and the possibility exists that more than 1 resuscitation may need to be done
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Describe a Premature Birth
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Any infant born prior to 8 months (36 Weeks)
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How are Premature babies different from full term babies
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Weight ( Less than 5 pounds)
The Vernix Caseosa (Baby Butter) will be missing or minimal The infants Bodily systems are under developed |
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What precautions should be observed when delivering a premature infant
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Keep infant warm
Keep mouth and nose suctioned Keep a special eye out for problems Give blow-by oxygen using nasal cannula (6) Do not infect the infant May need resuscitation |
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Describe Fetal Demise
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Infant is born Dead
Very emotional situation Do not attempt to resuscitate Infant may have sloughing skin or blisters and discolored Could be a foul odor |
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What is the initial Care for Every newborn
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Dry them off
Warm them up Position them so gravity aids in removing fluid from mouth and lungs Stimulate them to breath (cry) |
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What is APGAR scoring
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A way to rank newborns for possible problems
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When does APGAR scoring occur
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1 and 5 minutes after Delivery
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What doe the mnemonic APGAR stand for
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A - Appearance
P - Pulse or Heart Rate G - Grimace or Irritability A - Activity or Muscle tone or Movement R - Respiratory effort |
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How many points are awarded on the APGAR Scale
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0, 1 or 2 in 5 areas
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What is the name of the Kit carried on the Ambulance designed for newborn resuscitation
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Braselow
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When is Newborn Resuscitation necessary
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If breathing is shallow, slow or absent
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What should be done if the babies heart beat is less than 100
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Give artificial respiration at the rate of 1 every 3 seconds
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What needs to be done if the babies heart rate is less than 80 and not responding to ventilation
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Begin chest compressions at 100 beats per minute
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What needs to be done if babies heart rate is less than 60
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Chest compressions immediately
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What should be done if Central Cyanosis exists with spontaneous breathing and adequate Heart Rate
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Administer free flow (10-15)Oxygen via blow-by
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What is the term to describe a babies color when the finger and toes are blue
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Acroyanosis
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List some other Gynecological Issues
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Ovarian cysts
Pelvic Inflammatory Disease Middleschmirtz STDS |
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When should the EMT examine the Vagina in the case of Rape
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Only if profuse bleeding is present
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What is Endometriosis
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Baby growing outside of Uterus
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What is carried in the OB Kit
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Scalpel and clamps
Maxi Pad Baby Blankets Sterile gloves Bulb Syringe Towels Plastic bag |
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In what cases will you put the mother in the Knee-Chest position (Butt up and head down)
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When you cannot deliver or fully deliver the baby
Prolapsed Cord Limb Birth Presentation |
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How long should it take to deliver the placenta
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30 minutes
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