A 24-year-old first-time mother at 39 weeks gestation tells you her contractions are two minutes apart and lasting 60 seconds. She feels an overwhelming urge to push and states, 'The baby is coming!' Your partner confirms the infant's head is crowning.
What is the most appropriate course of action?
- Place the patient on a stretcher and begin immediate transport with lights and sirens to the hospital.
- Instruct the patient to pant and hold her legs together to delay delivery until hospital arrival.
- Prepare for an imminent on-scene delivery and call for additional resources and assistance. (correct answer)
- Establish a large-bore IV and administer a fluid bolus to prepare the patient for delivery.
Explanation: Crowning, frequent contractions, and the urge to push are signs of imminent delivery. Attempting to transport at this stage risks an uncontrolled delivery in the ambulance. The safest course of action is to prepare for delivery on scene, using a controlled and sterile technique, while calling for another unit for assistance with mother and baby post-delivery.