Labor and Disorder
What is the intervention for when a umbilical cord is in the vaginal canal?
Manual elevation of the presenting fetal part off the cord to restore blood flow. You can also reposition the mother. (knee/chest position)
Keep cord moist and clean.
Prolapsed cord
First Line Treatment for seizures in the ob patient diagnosed with eclampsia?
MAGNESIUM 4-6 iv/io in 100 ml bag over 15 minutes.
PCG 003
ETT size for a 35 week gestation neonate.
3.5-4.0
What are the night time minimums for flight?
5 miles, 1500 feet
What position do you place a pregnant patient and why?
left or right lateral recumbent
To prevent inferior vena cava syndrome. The vena cava is compressed. This will increase venous return, cardiac output and blood pressure.
What does Gravida mean?
How many times the patient Gets pregnant.
A reminder to use is the G in Gets pregnant for Gravida.
How often do we monitor fetal heart rate during transport?
every 15 minutes
pcg Q11
This pcg is the one that gives some good education regarding high risk ob flights.
what are you assessing?
Appearance
Pulse
Grimace
Activity
Respirations
Dose for blood product administration in pediatric patients?
10-20ml/kg with max of 30 ml/kg
Treatment of hypoglycemia in infants
D10W, 2ml/kg
What is McRoberts maneuver?
What is the iv epinephrine dose for a newborn weighing 3kg?
May repeat every 3 minutes
Mr Sopa stands for
Mask Adjustment
Reposition Airway
Suction
Open airway
Pressure increase
Advanced Airway
pediatric shock index range for a 5 year old
What is 1.2
Why is the shock index adjusted for pediatric patients?
Where do you find the OB risk assessment tool in image trends?
It is located under the worksheet. The same area where you go to get your signature from transferring
Hypertension, proteinuria, edema are signs of what OB complication?
Pre Eclampsia
What is the difference between eclampsia and pre eclampsia?
May see late decelerations on the tocomonitor or ask the nurse if there has been any late decelerations.
What causes pre eclampsia?
Push dose pressor dose for pediatric patient?
1mcg/kg max 10mcg per dose, every 5 minute.
PCG 27
What is the maintenace fluids for a 33 kg pediatric patient
4mlx10= 40
2mlx10-20
1mlx13=13
maintenance fluids of 73ml/hour
Q10
What parameters are assessed for SIRS criteria?
temp greater than 38.3( 100.9 ) or less than 36(96.8)
tachycardia, tachypnea, co2 less than 32, altered mental status, hyperglycemia 140, elevated wbc, elevated lactate
scene flights I usually go by elevated temp, the low co2, altered mental status, temp and suspected source of infection
Must have 2 or more from the list with one of them being either temp or wbc.
talking points--if you suspect this sirs/sepsis on scene and go to intubate then what might you change or do to set yourself up for success?
What change do you make to the neo tee if you are not seeing rise of the chest?
increase your pip
How much blood loss is considered post partum hemorrhage and what is the treatment?
500ml or greater within 24 hours of delivery.
First Line treatment is a fundal massage. Be vigorous!
Fundus is the top of the uterus. If you are at the hospital ask for pitocin.
Ae pcg oo1
Dose of txa for a pediatric patient?
2-12 years of age is 15mg/kg over 10 minutes then 2mg/kg/hour over 8 hours
txa given to fast can cause hypotension. Pediatrics are extremely susceptible to changes in blood pressure.
What is the first sign of compensation for shock in a pediatric patient?
tachycardia
Children have mostly fixed/ limited stroke volume. Cardiac Output(hr x stroke volume). They cant increase stroke volume so they increase heart rate.
Their blood pressure will remain normal due to strong peripheral vasocostriction therefore the heart rate will be the compensating factor.
Hypotension is a late sign. Look at your clinical indicators such as tachycardia, pale, cool and anxious.
This maneuver is used in assisting a breach delivery
Mauriceau maneuver
infants body is supported by the right forearm while traction is mae upon the shoulders by the left hand, maintaining the head in the in flexed position. The index and middle fingers are placed oer the maxillary prominence on either side of the nose.(google the picture)
I think of the way a quarterback receives a snap from the other player.
You have 1200 in your main o2 tank. You received a transfer of a patient on NIV going from Caldwell County Ky to Tristar Hendersonville. How much useful oxygen do you have in minutes?
98 minutes
any concerns? considerations for flight?