Obstetric Emergencies - NREMT: AEMT Level

Left lateral tilt to reduce supine hypotensive syndrome. Left lateral positioning displaces the gravid uterus off the inferior vena cava, improving venous return and cardiac output in hypotensive patients.

Knee-chest or Trendelenburg to relieve cord compression. These positions elevate the presenting part off the cord, reducing compression and maintaining fetal blood flow during transport.

Painless bright red vaginal bleeding. Placenta previa involves low placental implantation covering the cervix, resulting in painless bleeding from vessel disruption during dilation.

Painful vaginal bleeding with uterine tenderness. Abruptio placentae causes placental separation leading to painful bleeding and tenderness due to blood accumulation and uterine irritation.

Preeclampsia with seizures; manage airway and prevent injury. Eclampsia is a severe complication of preeclampsia involving convulsions, requiring immediate airway protection to prevent aspiration and trauma.

Pregnancy hypertension with signs such as headache or edema. Preeclampsia involves gestational hypertension often with proteinuria, and symptoms like headache or edema signal potential progression to eclampsia.

Anterior shoulder trapped; perform McRoberts maneuver. Shoulder dystocia involves impaction behind the pubic symphysis, and McRoberts maneuver flexes hips to widen the pelvic outlet.

Do not attempt delivery; cover with sterile dressing; transport. Limb presentations indicate malposition requiring cesarean delivery, so avoid manipulation to prevent cord prolapse or injury.

Onset of contractions to complete cervical dilation. This stage encompasses the dilation phase, beginning with true labor contractions and ending when the cervix reaches 10 cm dilation to prepare for fetal expulsion.

Complete dilation to delivery of the newborn. This expulsion stage starts once the cervix is fully dilated and involves active pushing until the baby is completely delivered from the birth canal.

Delivery of the newborn to delivery of the placenta. This placental stage follows the baby's birth and involves uterine contractions that separate and expel the placenta to complete the delivery process.

Approximately 37 to 42 weeks. Full-term gestation is defined as this range to ensure fetal maturity, with pregnancies outside it considered preterm or post-term.

Support the perineum and control delivery of the head. Supporting the perineum prevents tearing and controls the head's emergence to minimize trauma during the expulsion phase.

Gently slip cord over head; if tight, clamp twice and cut. This action relieves potential cord compression around the neck, ensuring fetal oxygenation without causing cord trauma.

Suction only if airway obstruction or inadequate respirations. Guidelines recommend suctioning only when necessary to avoid unnecessary trauma, as most newborns clear meconium without intervention.

Assess at 1 minute and 5 minutes after birth. Apgar scores evaluate newborn adaptation at these intervals to identify need for resuscitation and monitor improvement.

Appearance, Pulse, Grimace, Activity, Respirations. These components assess the newborn's color, heart rate, reflex irritability, muscle tone, and breathing effort for a total score out of 10.

Create airway with two fingers in vagina; rapid transport. Creating a vaginal airway facilitates fetal oxygenation when the head is entrapped, with rapid transport needed for surgical delivery.

Support body; allow head to deliver; do not pull. Supporting without pulling allows natural delivery progression while minimizing risk of nerve injury or trauma in breech presentation.

Fundal massage with support; treat for shock. Fundal massage promotes uterine contraction to control bleeding, while shock treatment addresses hypovolemia in postpartum hemorrhage.

Do not pull cord; manage hemorrhage and transport rapidly. Pulling risks uterine inversion or increased bleeding, so focus on hemorrhage control and urgent transport for hospital intervention.

Inspect for completeness and transport with the patient. Inspection ensures no retained fragments that could cause infection or bleeding, and transport allows hospital evaluation.

Cord presents before the fetus, often visible at the vagina. Prolapse occurs when the cord descends ahead of the fetus, risking compression and fetal hypoxia if not addressed promptly.

Insert gloved hand and lift presenting part off the cord. Manual elevation relieves pressure on the prolapsed cord, preserving umbilical blood flow until definitive care is available.