Mom
You respond to a pregnant woman having contractions about 4mins apart. What are two focused questions you should ask?
Is this your first child? Have you been able to have prenatal care? How far along in your pregnancy are you? Have you had any problems during your pregnancy?
Where is the OB Kit usually found in the ambulance?
Driver side, upper rear cabinet
A 30mmHg increase in the systolic pressure (or 15mmHg diastolic) during pregnancy is diagnosed as what? Or suspect this if the B/P is >140/90
Preeclampsia
What do the letters in APGAR stand for?
Appearance / Pulse / Grimace / Activity / Respirations
Delivery appears imminent but the only thing presenting is the umbilical cord (Prolapsed Cord). What should you do?
Goal: Prevent cord from being compressed and keep mom/baby oxygenated. Use 2 fingers to keep pressure off cord, apply Oxygen, cover cord with sterile moist dressings.
Mother says this is her second child. What is a good follow-up question?
How did your first delivery go? Did you have any problems with delivering your first child?
A sign that childbirth is imminent!
Crowning, an urge to push, contractions </= 2mins
You respond to a pregnant woman who had a seizure and you are told she has preeclampsia. This marks the transition to what disorder?
Eclampsia
What is the min / max score APGAR score an infant can have?
Scoring goes from a min of 0 to a high of two and so the Min is 0 and the Max would be 10
Immediately after delivery, baby is cyanotic and doesn't appear to be breathing. What are your first step(s)?
Dry, Warm, Suction, and Stimulate
Abdominal pain in a female of reproductive age should be assumed to be what until proven otherwise?
Ectopic pregnancy
As the infant's head is delivered you see that the umbilical cord is around the neck (Nuchal Cord). What should you do?
Slip the umbilical cord over the head or shoulders
Placenta Previa
The newborn's pulse is 120. How many points under "P" in APGAR would it receive?
No pulse = 0 , Less than 100 = 1, >100 = 2
After drying, warming, and stimulating the baby is breathing irregularly and the heart rate is <100 bpm. What should you do next?
Provide 02 and initiate ventilations
This medication should be used cautiously during the first trimester of pregnancy and reserved for severe dehydration and intractable vomiting
Ondansetron
What should you do after the infant's head is born?
Support the head and suction the nose and mouth if the airway is not clear
Increased maternal age, multiparity, trauma, and cocaine use all increase the risk of this life threatening placental issue called what?
Abruptio Placentae
The newborn is breathing irregularly. How many points in APGAR would you give in under the "R" category?
Absent respirs = 0, weak or irreg = 1, strong cry =2
When should you initiate chest compressions on the newborn?
Heart rate less than 60bpm
In general how does mom's blood volume, heart rate, and blood pressure change during a normal pregnancy?
Blood volume increases by up to 50%
Heart rate increases by about 10-15 bpm
B/P may lower first and second trimester then normal for third
When and where do you cut the umbilical cord?
After pulsations cease (~30-45 secs after delivery); Place two clamps about 2-3" apart w/ the first clamp about 4" from infant. Cut between the clamps.
What do you call severe nausea and vomiting that can lead to dehydration and weight loss and may persist throughout pregancy?
Hyperemesis Gravidarum
Score this: The head and body is pink but extremities are blue, the pulse is 90, the baby's facial expression only seems to change when touched, the extremities are moving a little bit, and the baby is breathing irregularly
A=1, P=1, G=1, A=1, R=1.....Score = 5
Mother is still bleeding after delivery and the placenta has not delivered. What should you do?
Fundal massage, encourage mother to breast feed, IV and fluids