obstetrics and normal delivery
what is the typical length of a full term pregnancy
40 weeks
what classic triad suggests ectopic pregnancy
amenorrhea
unilateral abdominal pain
vaginal bleeding
which pulse oximetry site is preductal and preferred for neonatal spo2
right hand
what are the 5 rights
right patient
right drug
right dose
right route
right time
what does LVAD stand for and one key prehospital consideration
left ventricular assist device
may have no palpable pulse; assess perfusion by mental status, skin color, ETCO2
at approx. what week is the fundus at the umbilicus
20 weeks
painless bright red bleeding in the 2nd/3rd trimester is most suggestive of what dx
placenta previa
what is the MR SOPA mnemonic used for
mask
reposition
suction
open mouth
pressure increase
alternate airway
which organ is the major site of drug metabolism
liver
for a patient with a tracheostomy, what is one crucial piece of information to get from caregivers
whether the tube has an inner cannula and whether it is fenestrated, size and cuff status, and baseline suctioning needs
list 3 stages of labor
1. dilation stage
2. delivery of baby/expulsion
3. placenta delivery
what is the key difference in presentation between abruptio placentae and placenta previa
abruption = painful bleeding with rigid tender uterus
previa = painless bright red bleeding
what is the chest compressions: ventilations ratio for neonates during CPR
3:1
define pharmacodynamics
what the drug does to the body (effects and mechanisms of action)
list the steps for managing a cord prolapse
call for rapid transport
position mother (knee-chest or trendelenburg)
insert two fingers and lift presenting part off cord and maintain that until hospital
keep cord moist with saline dressings
do not push cord back in then remove fingers until definitive care
what immediate steps should you do for a vigorous newborn in the first minute (3)
dry, warm, stimulate
kangaroo care
delayed cord clamping if stable
define preeclampsia (basic diagnostic criteria)
BP > 140/90 after 20 weeks + preoteinuria(or evidence of organ dysfx)
list 3 immediate steps in neonatal resuscitation if the newborn is apneic and term
warm/dry/stimulate
open a/w and suction if needed
start PPV with BVM and appropriate mask
what type of medications ends in "-pril"
ace inhibitors
describe the initial on-scene management for PPH
fundal massage to encourage contraction
encourage voiding if needed
prepare oxytocin
name 4 signs that the placenta has separated
sudden gush of blood
lengthening of the cord
uterus becomes firmer and more globular
fundus rises in the abdomen
list 4 maternal risk factors that increase the change of preeclampsia
primigravida
multiple gestation
chronic HTN or kidney disease
diabetes / obesity
maternal age <18 or >35
name three congenital conditions commonly associated with cyanosis in neonates
transposition of the great arteriescritical ductal-dependent lesions
explain drug potentiation in one sentence
potentiation occurs when one drug increases the effect of another, producing a combined effect greater than the sum of each alone (e.g., benzos + alcohol)
list 5 H's and 5 T's
hypoxia
hypovolemia
hydrogen ionns (acidosis)
hypo/hyperkalemia
hypothermia
tension pneumo
tamponade
toxins
thrombosis
trauma