Activate or Hesitate
A pregnant patient presents via private vehicle after a minor fall at 20 weeks gestation, denies abdominal pain
What is NO OB Trauma Activation, but follow remaining OB policies (transfer to OBED)?
Pregnant women may lose a significant amount of blood before showing traditional signs of shock because of this physiologic change
what is increased blood volume
One of the most common serious complications after blunt trauma in pregnancy
What is placental abruption
Most important focus during maternal cardiac arrest
This acronym stands for the maneuver used to relive aortocaval compression
what is LUD - Left Uterine Displacement
the new name reflects the primary purpose is this
what is maternal resuscitation
MVC at 30 weeks, restrained driver, airbag deployment, reports abdominal pain
What is Activate Level 2 OB Trauma?
Cardiac output increases by this % during pregnancy
30-50%
This monitoring method is more sensitive than ultrasound for detecting abruption
what is fetal monitoring
Without maternal survival, this patient cannot survive
Who is the fetus
A 34 week pregnant patient in cardiac arrest and no one is addressing uterine compression
what is initiate left uterine displacement
The uterus should be at or above this landmark when considering resuscitative cesarean section
what is the umbillicus
28 week patient arrives after a fall down a full flight of stairs, reports pain in L arm, head, and abdomen
What is Activate Level 2 OB Activation and consider Level 1 Activation after VS assessment?
what is 600 mL per minute
A minor trauma can still cause this complication
What is placental abruption
Most likely rhythm in traumatic maternal cardiac arrest
What is PEA
This physiologic problem is relived by LUD
what is aortocaval compressoin
What time should the resuscitative cesarean start by
what is 4 minutes after arrest
Patient arrives via EMS after MVC with SBP 88, tachycardic, pale and vaginal bleeding.
A pregnant trauma patient appears stable, talking normally with normal BP - what dangerous assumption should you avoid
what is assuming the patient is not significantly injured - because pregnancy can mask shock?
A patient has abdominal pain and uterine tenderness after low speed MVC but no vaginal bleeding
What is suspected placental abruption - concealed hemorrhage
IV or IO access should be placed above this anatomical landmark
bonus -- why
what is the diaphragm
During maternal resusciation, the physician states we should move to the OR for a c/s
what is communicate that resuscitative c/s should be performed at the sight of arrest
The baby should ideally be delivered by this minute
what is 5 minutes after maternal collapse
24 week patient arrives after physical assault 6 hours ago, now with abdominal pain, vaginal spotting, and decreased fetal movement.
??? Discuss appropriate activation
A patient appears stable but suddenly becomes hypotensive after trauma
what is maternal compensation followed by sudden decompensation?
The uterus has this property but the placenta does not, creating shearing forces during trauma
what is elasticity
Patient develops VF and team members hesitate to shock due to pregnancy
What is defibrillate immediately without delay
If you can only remember ONE thing from today what should it be
LUD!!!!
Out of hospital arrest - patient arrives without ROSC, fundus above umbilicus, team is waiting for OB to arrive
What is do not delay - advocate and prepare for resuscitative cesarean